Background: The role of research was supported by faculty, researchers and professional organizations as an essential standard for practice and professional accountability. It is important to equip students with a strong research foundation to facilitate judging applicability of findings to clinical settings, and conducting research and eventually improving the quality of health-care. Increasing attention is directed to students' attitudes and involvement in research, however, no previous studies were located on the attitudes of Saudi students towards research. Aim: To investigate the attitudes of nursing students toward research in Saudi Arabia. Materials and Methods: A descriptive design with convenient sample of 244 senior students at a three-campus college of nursing in three regions in Saudi Arabia using a 22-items self-administered 4-point likert type attitude questionnaire. Results: Majority of students reported positive attitudes toward research with highest scores for 'usefulness of research' and 'personal interest in research' and lowest scores for 'using research in clinical practice'. Research attitudes significantly correlated with students' seniority and having completed a research course. Conclusions and Recommendations: Assessing students' attitudes towards research enhances implementation of findings in patient care and proposes means for developing positive attitudes and raising students' awareness of future role as practicing nurses. Students had positive attitudes toward research and its usefulness in professional work and less positive attitudes toward using research in practice. Faculty should develop students' knowledge and attitudes while studying at the college. Nursing and health-related professions researchers should direct attention to promoting the ultimate implementation of evidence-based practice by students as well as nurses

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Background: Pre-eclampsia is a pregnancy-specific disorder recognized clinically by the onset of hypertension and proteinuria. It complicates about 2%-10% of pregnancies worldwide and contributes to maternal and foetal morbidity and mortality. However there is paucity of information on its prevalence in Calabar. Aims: To determine the prevalence of pre-eclampsia in the University of Calabar Teaching Hospital, Calabar, Nigeria over a period of 3 years for the purpose of further genetic studies. Settings and Design: A descriptive epidemiologic study that consisted of all documented cases of Pre-eclampsia in a tertiary referral center from 2009 to 2011. Materials and Methods: Data on pre-eclamptic patients were obtained from the Records Department of the hospital. Statistical Analysis: The results were anaylzed using SPSS version 17, percentages, mean and standard deviations were used to describe data. Results and Conclusions: A total of 8,524 deliveries and 104 cases of pre-eclampsia were documented giving an overall prevalence of 1.2%. The prevalence in 2009, 2010, and 2011 was 0.7%, 1.2%, and 1.5%, respectively. Fifty-nine case notes were available for analysis (56.7% retrieval). The mean age of the patients was 27 ± 4.9 and majority; 25 (42.4%) were in the age group 25-29 years. The mean parity was 1.1 ± 1.4 and 26 (44.1%) were nulliparous. 11 (18.6%) had family history of hypertension, 2 (3.4%) had personal history of hypertension, and 2 (3.4%) had a personal history of pre-eclampsia. The slight increase in the prevalence rate over the years underscores the need for close surveillance.

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Background: Iron-deficiency anemia is a public-health concern in developing countries. Weekly iron folic acid (IFA) consumption can significantly reduce the prevalence of nutritional anemia among adolescents. The government of India launched the Weekly IFA Supplementation (WIFS) programme in 2012 to the reduce prevalence and severity of nutritional anemia among adolescent population. Objectives: To study factors influencing WIFS programme at selected schools in rural Puducherry and to explore perceptions regarding WIFS programme qualitatively. Methodology: A school-based cross-sectional study was conducted during July-December 2013 in selected government schools of Bahour commune in rural Puducherry. After obtaining permission from school headmasters, a total of 240 school children (both boys and girls from 9 ^th to 10 ^th standards) were interviewed. Pretested pro forma in local language was used, and multistage sampling technique was followed for quantitative data collection. Qualitative information was collected through 6 focus group discussions. Data were analyzed using SPSS version 17.0 (SPSS Inc., Chicago, Illinois, USA) and Anthropac 4.98.1/X software. Results: About 47.2% children were consuming IFA tablets regularly, 52.8% were consuming occasionally or rarely. Stomach pain (41.7%), nausea and vomiting (24.5%), and disliking of tablets (22.3%) were predominant causes for IFA tablet refusal. Reduced fatigue (43.7%), increased appetite (41.1%), and improved concentration (37.7%) were cited as major benefits of IFA tablets. Gender, type of family, parents' education, and occupation were not associated with consumption of IFA tablets. Girls perceived that IFA tablets causes weight gain, and may have side effects such as bad taste, pain abdomen, and giddiness. Boys considered that these tablets were not necessary and have side effects such as stomach pain and nausea and often throw away tablets. Occasional unavailability of IFA tablets, poor awareness regarding importance of IFA tablets, and casual programme implementation were other important factors. Conclusion: Creating awareness regarding the importance of IFA supplementation and careful programme implementation including regular supply of IFA tablets should be considered to make WIFS programme successful.

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Background: Electronic health record (EHR) applications improved quality and diminished health services cost. Aims: Project aimed to determine utilization and barriers of EHR by physicians. Settings: Three governmental hospitals in Eastern Province in Saudi Arabia adopted EHR system with the same software and functionalities. Design: Study was cross-sectional. Materials and Methods: EHR functionalities tool of a previous study was used. Additionally, tool included physicians' data and barriers of utilizing functionalities. Response scale of using functionalities was 'used' or 'not used'. Questionnaires were distributed among physicians working in departments adopting EHR. Overall response rate was 57.5% (319/555). Results: There was under-utilization of almost all functionalities. The least one was 'data back-up and disaster recovery' (18.2%) and the highest was 'enter pharmacy orders' (96.2%). There was no use of communication tools with patients as e-mails, facsimile and short messages. Physicians had no access to charts while they are outside hospital. Patients had no access to records. There was under-utilization of Automatic International Classification of Diseases (ICD) (27.6%). Most common barriers were system hanging up (86.5%), loss of access to records transiently if computer crashes or power fails (85.6%), fastness in utilizing system (84.3%), and system takes additional time for data entry (83.4%). Lack of continuous training/support from IT staff in the hospital (79.3%), lack of customizability of the system according to users' needs (78.1%), complexity of technology (74%), disturbing patient-doctor communication (71.2%, P < 0.05), and lack in belief in EHR adoption (63.6%, P ≤ 0.05) were cited. Conclusions: Under-utilization of most of functionalities. Physicians should be encouraged to use it via overcoming the obstacles.

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Objectives: Birth control or contraception has become a fundamental part of women's healthcare. Multiple studies have been conducted to determine women's knowledge of contraception. This study aimed to know the patterns of contraception use and to assess the knowledge of contraceptive methods among women living in Jeddah, Saudi Arabia. Methods: A cross-sectional previously validated survey was carried out between June and December 2016 among female Saudi citizens aged 18 years or older and living in Jeddah City, Saudi Arabia. In total, 979 female participants responded to the questionnaire. Results: The prevalence of contraceptive use among Saudi women living in Jeddah was 67.7%. Preventing pregnancy was the most frequent reason for using contraception (69.7%). Oral contraceptives were the most commonly used contraceptive type used (31.8%) followed by intrauterine devices (21%). Almost 16.4% used the withdrawal method, and the male condom method was used by 13.6%. Mood swings and depression were the most common side-effects encountered (34.6%). Furthermore, primary educated individuals reported significantly less contraceptive use compared to individuals who had a high level of education by 47% (odds ratio = 0.53, 95% confidence interval = 0.3–0.95). Age, years of marriage, and number of children were not shown to have any significant effects on contraception use among the participants. Conclusions: The study showed knowledge gaps in the use of different contraception methods. The most common contraceptive methods among Saudi women in Jeddah are pills and intrauterine device. Education played a big role to use the different type of contraception. Effective strategies should be implemented to raise awareness of the appropriate use of contraceptives and dispel misconceptions.

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Introduction: Non-fermenting gram negative bacilli (NFGNB) are taxonomically diverse group of pathogens that has emerged as a major cause of health care associated infections especially in immunocompromised hosts. Identification of NFGNB and monitoring their susceptibility pattern are important for proper management of infections caused by them. Prevalence and antibiogram of NFGNB has not yet been reported from this part of India. Aim of the present study was to characterize the prevalence of NFGNB along with their antimicrobial sensitivity pattern among the patients coming to our hospital a tertiary care center. Materials and Methods: A total of 2585 various clinical specimens were received in laboratory and were processed. Non fermenters were identified using a standard protocol. Antimicrobial susceptibility testing was performed by Kirby Bauer disc diffusion method. Results: Among 2585 clinical samples 241 yielded NFGNB accounting for an isolation rate of 9.32% and a total of 246 non fermenters were grown as five samples yielded two types of NFGNB. Pseudomonas species (49.59%) and Acinetobacter species (43.09%) were the most commonly isolated NFGNB. A high level of antibiotic resistance was recorded for most of the first and second line drugs. Imipenem and amikacin were the drugs with maximum activity. Overall imipenem resistance was found to be 30.54%. Conclusion: Identification of NFGNB and monitoring their susceptibility patterns will help in proper management of infections caused by them. Improved antibiotic stewardship and infection-control measures will be needed to prevent or slow the emergence and spread of multidrug-resistant NFGNB in the healthcare setting.

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Aim: This study was designed to test the Sudanese parents' knowledge, attitudes and practice (KAP) toward self medicating their children. Design and Methods: A cross-sectional study was carried out by using a pretested questionnaire. Non probability convenient sampling method was used to select the participants. The total sample size was 1000 parents from different health settings in Khartoum State, Sudan in the period from January to June 2011. Results: The obtained response rate was 94.9%. The majority of Sudanese parents in this study 84% used to recommend western medicines to their children. More than one-third of children had received parental self medication in the month preceding this study. The results revealed that parents in 95.7% cases, self medicated their children from minor illnesses. The most frequently used medicines are antibiotics 36.6% followed by paracetamol 31.5%, even though the most common symptom reported was fever 39.7%. In case of self-treatment failure; 64.0% of responded parents used to consult physicians in public settings, while 8.0% seek advice from the community pharmacists. The main reasons of parental self medication were the expensive consultation fees and the long waiting time in the clinics. Conclusion: The study revealed that parents' knowledge was inadequate, and their parental self medication practice showed to be inappropriate. The study outcomes urge instant move toward educating parents on risk of liberal use of medicines in children.

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Background: Pseudomonas aeruginosa is an aerobic, motile, Gram-negative rod which is responsible for 10% of all hospital-acquired infections. Objectives: This study was conducted to determine the frequency, risk factors and antibiotic resistance pattern of P. aeruginosa isolated from various clinical samples. Materials and Methods: Present retrospective hospital record based cross-sectional study included a total of 6280 clinical samples collected from patients at a tertiary care hospital, South Odisha, India from January 2011 to December 2012. Samples were processed and identified by standard protocol. The P. aeruginosa was tested for antibiotic resistance by Kirby-Bauer disc diffusion method (according to Clinical and Laboratory Standards Institute guidelines). Results: From 6280 clinical samples, 3378 (53.8%) samples yielded significant growth and 327 samples were positive for (9.7%, 327/3378) P. aeruginosa (6.8% of nosocomial and 2.9% of community-acquired infections). Maximum 221 (67.6%) isolates were obtained from pus/swab, followed by urine 15% and blood (4.9%). Elderly, in-patients and invasive procedures were found to be significant risk factors in the setup investigated (P < 0.05). Out of 327 isolates, 277 (84.7%) isolates were multidrug-resistant, 99 (35.7%, 99/277) isolates were extensively drug-resistant. No pandrug-resistant isolate was obtained. Majority of isolates were sensitive to imipenem, meropenem and piperacillin/tazobactam, showed the least resistance rate of 6.4%, 8% and 11.3% respectively. Conclusion: This hospital based epidemiological data will help to implement better infection control strategies and improve the knowledge of antibiotic resistance patterns among clinicians. Thus, there is a need for periodical antimicrobial surveillance to monitor the resistance patterns in local hospitals.

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Context: The study of medicine is extensive, time-consuming, and highly stressful, especially during preclinical study period. Aim: To assess perceived stress in medical students studying in a medical college in Saudi Arabian Eastern Province and observe any gender-related variations in stress. Study and Design: Cross-sectional comparative study. Materials and Methods: The present study was carried out in College of Medicine, University of Dammam using Arabic version of Perceived stress scale-10 questionnaire. Eighty students (40 males and 40 females) studying in 2 ^nd year were included in the study. Statistical Analysis: Data were analyzed by using Microsoft Excel and SPSS version 19. Descriptive analyses were conducted to determine the frequency distributions of the study variables. Independent sample t-test was used to compare stress scores among male and female students. Stress level was analyzed by quartiles of perceived stress. Results: The overall prevalence of stress found in this study was 71.7%. Mean perceived stress score of all the students was 17.31 ± 5.31. There was no significant difference in the mean stress scores of males and females students. The percentage of students with no, mild, moderate, and severe stress was found to be 28.3%, 21.7%, 31.7%, and 18.30%, respectively. Conclusions: The present study indicates of high prevalence of stress in these medical students in the preclinical years. Hence, there is a need to take measures by the authorities to reduce stress among students.

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Background: Knowing etiology and antimicrobial susceptibility patterns of bacterial isolates from patients with community-acquired pneumonia (CAP) is important in reducing the morbidity and mortality. Objective : To determine the bacterial etiologies and antimicrobial susceptibility pattern of isolates from patients with CAP. Materials and Methods: Cross-sectional study was conducted from March to July 2012. Sputum and blood specimens were collected, and microbiological investigations were performed using standard procedures. Data were presented using descriptive statistics. Results : Bacterial isolates from both sputum and blood cultures of patients were similar. Most common bacterial isolates from gram-positive bacteria were Streptococcus pneumoniae (12.8%) and Staphylococcus aureus (10.5%) and from gram-negative bacteria were, Pseudomonas aeruginosa (6.8%), Klebsiella. pneumoniae (5.3%), and Escherichia coli 3.8%. Most S. pneumoniae isolates were resistant to oxacillin (55%). High resistance rates of S. aureus isolates were observed to tetracycline (100%), penicillin (81.3%), trimethoprim-sulfamethoxazole (81.3%), erythromycin (75%), and doxycycline (50%). Gram-negative bacteria isolates were resistant to tetracycline (66.7-100%), doxycycline (50-100%), trimethoprim-sulfamethoxazole (66.7-100%), and ampicillin (66.7-100%). Resistance to two or more drugs was also observed among 62.7% of bacterial isolates. Conclusion: High rate of antimicrobial resistance was observed to commonly prescribed antimicrobial agents for CAP as empiric therapy.

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Background: Neural tube defects (NTDs) consist of a variety of central nervous system abnormalities, most of which result from a lack of closure of the neural tube. Aims and Objectives: The study aimed to determine the prevalence of NTDs among women delivering in the labor room suites of a tertiary health institution in North-Western Nigeria. Subjects and Methods: This was a 3-year prospective study carried out in the Department of Obstetrics and Gynecology in association with the Department of Pediatrics. All neonates delivered in the labor rooms were examined for NTDs soon after birth. Those diagnosed with NTDs were admitted into the special care baby unit for observation and documentation. Results: There were 10, 163 deliveries and NTDs were present in 22 cases, thus giving a prevalence of 2.2/1000 deliveries. The common types of NTDs were spina bifida 72.7% (16/22), anencephaly 22.7% (5/22), and encephalocele 4.6%. There was a preponderance of females, with a female to male ratio of 1.4:1. Hydrocephalus was the most common associated anomaly 36.4% (8/22). The mothers were mainly within the age range of 20-35 years 59.1% (13/16), parity 2 or more and of low-socioeconomic status. Diagnoses were made by antenatal ultrasonography 50% (11/22) and clinically (50%) after delivery. The perinatal mortality was 81.8% (18/22). Conclusion: The prevalence of NTDs in this study is in consistent with literature. Improvement in maternal nutrition and antenatal folate intake is recommended.

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Introduction: Iron-deficiency anemia (IDA) is quite common in female adolescents and adults worldwide. Despite the higher prevalence of IDA, there is a paucity of research in finding its prevalence and potential causes in young Saudi female population. Thus, the aim of this study was to determine the prevalence and possible causes of IDA in young female medical students and search for risk factors in the studied group. Materials and Methods: One hundred and twenty female students from Imam Abdulrahman Bin Faisal University were selected by randomized sampling whose blood samples were taken to measure their hemoglobin (Hb) and serum ferritin levels. According to the World Health Organization criteria, individuals with Hb <12 g/dL and ferritin <15 ng/mL were considered anemic. The sociodemographic, gynecological, and dietary data were collected from all the respondents with the help of a well-designed 15 items questionnaire. The association between IDA and the potential risk factors was found through Fishers' exact test or Chi-square test. Results: Among the studied group, 38.3% of total population were anemic. Mean Hb ± standard deviation (SD) was found to be 12.6 ± 1.3 and mean ferritin ± SD was 18.9 ± 5.2. No statistically significant correlation (P > 0.05) was found between IDA and the background, gynecological history, and dietary habits of the anemic participants. Conclusions: The higher prevalence rate of anemia among Saudi female medical students (38.3%) was similar to the earlier reports of the Gulf region. Considering the higher ratio of anemic students, iron supplements should be prescribed to the affected youngsters to improve their Hb level.

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Background: Human immunodeficiency virus (HIV)-infected patients are now recognized as one of the higher risk groups for increased rates of both methicillin-resistant Staphylococcus aureus (MRSA) colonization and infections over the past decade. Staphylococcus aureus are known to colonize the anterior nares of HIV-infected patients with greater frequency than that of the general population, leading authors to postulate that this higher colonization burden might translate into a higher incidence of infections. Settings and Design: The study was a prospective study, including HIV-infected patients. Exclusion criteria: Patients having diabetes or any other immunodeficient conditions besides HIV. Materials and Methods: One hundred and forty two non-duplicate patients with HIV infection, attending the anti-retroviral therapy (ART) center at a tertiary care hospital were studied for nasal carriage of MRSA and associated factors affecting nasal colonization. Nasal swabs were used for isolation of S. aureus. MRSA were detected by using cefoxitin (30 μg) disc as per the Clinical Laboratory Standards Institute (CLSI) guidelines. Careful examination for dermatoses was carried out. Statistical Analysis: Descriptive statistics and testing of hypothesis were used for the analysis using SPSS 16 software. Results and Conclusions: Seventy two (50.70%) of the 142 patients were colonized with S. aureus in the anterior nares. Significant number of S. aureus carriers were in the 31-40 year age group. Methicillin resistance was found in 26 (36.11%) isolates. Cotrimoxazole prophylaxis was found to be a risk factor for MRSA colonization (P < 0.0001). Decreased CD4 counts was found to be a significant risk factor for MRSA colonization (P < 0.0001).

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Introduction: In the wake of fast paced life and cut throat competitions, students are under high academic pressure. Neuroendocrine system plays a vital role not only in supporting normal physiological function but also during stress. It influences the endocrine and reproductive system to help in adaptation and maintains homeostasis in response to stressors. Material and Methods: Study was done on 100 female college students (50 medical and 50 non-medicals). Based on the questionnaires each participant was evaluated for level of stress and variations in menstrual patterns like length, duration, dysmenorrhoea, premenstrual tension etc. Result: Significant association was observed between the level of stress and presence of premenstrual symptoms (P = 0.002). Higher stress was associated with passage of clots (P = 0.01), painful periods (P = 0.012) and the presence of premenstrual symptoms (P = 0.002). Higher number of medicos suffered from premenstrual symptoms compared to non-medical students (60%, 40%, P = 0.046). Conclusion: A strong association was observed between stress and premenstrual symptoms. There is no difference in medical and non-medical students either in the stress level perceived or in any of the menstrual complaints except for premenstrual tension (P = 0.046) which may be as 62% of medical students perceived above average or higher level of stress compared to 50% non-medicos.

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Aims: This study aimed to determine the types of, the frequency of, and reasons for social media usage by patients. In addition, this study attempts to explore patients' perceptions of the advantages and main challenges associated with using social media in healthcare. Subjects and Methods: This was a cross-sectional study. Questionnaires were distributed to a convenience sample of 400 patients at a teaching hospital in Eastern Province, Saudi Arabia. The data were analyzed by performing descriptive and inferential statistics. Results: Of the 400 patients, 377 patients used social media. Females were more frequent users (60.7%) of social media than males (39.3%). Young patients were more frequent users of social media than older patients. Most patients used social media daily. The patients reported that the main purpose of their usage of social media was to care for their own health. The main advantage was to enable patients to learn about the symptoms of their illness and the method of treatment. A small percentage of patients believed that using social media in healthcare might breach the confidentiality and security of their information, which was the main challenge associated with using social media in healthcare. Conclusion: Social media is revolutionizing healthcare delivery, and its benefits overcome its drawbacks.

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Aim: Self-medication is developed to encourage responsible self-care but is often carried out without sound rationality. This study assesses the reasons, knowledge, attitude, and practices toward self-medication in rural areas of south-western Saudi Arabia. Materials and Methods: A cross-sectional, descriptive, and questionnaire-based study was carried out on respondents visiting the primary healthcare center. Data were collected, analyzed using SPSS software version 23 and presented as frequencies and percentage. Association between variables was established using the Chi-square test, and logistic regression. Results: Among the 500 responses obtained, 58% were female, and 42% were male. Self-medication was practiced for pain (38.3%), influenza (26.3%), cough (24%), and allergy (11.4%). Over 70% failed to consult a physician, lacked awareness of medicine information inserts (71.06%), and failed to check the expiration date (85.2%). Recurrence of symptoms and accessibility of medicines in pharmacies or online stores were a widely accepted reason for self-medication. The respondents were 2.5 times likely to use medications based on others recommendations (odds ratio [OR]: 2.56; 95% of confidence interval [CI]: 1.59–4.13); however, this was lower in females (OR: 0.55; 95% CI: 0.38–0.79; P = 0.002). A significant association was observed between the reasons for self-medication and practices undertaken if symptoms persist with demographic characteristics. Conclusion: Recurrence of symptoms, adopting others advice, the absence of information about medication inserts, and expiration date were issues that can impede responsible self-medication in rural areas. Appropriate patient counseling and conscious dispensing of medications are needed to minimize risks associated with self-medication.

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Spontaneous reporting of adverse drug reactions (ADRs) by health-care professionals is the basic method for the identification and prevention new and serious ADRs of marketed drugs. The contribution of nurses in this task can improve patient safety and reduce the extra financial burden associated with it. Although a total of 11% of ADRs in National Pharmacovigilance and Drug Safety Center were reported by nurses. The objectives of this review were to identify the possible factors that lead to underreporting of ADRs by nurses and define strategies that increase the reporting. This review has revealed various factors that influence the underreporting of ADRs and strategies to encourage reporting by nurses. Most of the identified factors are potentially modifiable. To overcome the underreporting of ADRs by nurses' main interventions should be based on education, motivation, and determination.

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Background: The prevalence of asthma has increased considerably in the last few years. Aims: The aim of this study was to assess the prevalence of asthma and its related risk factors among children in Taif, Saudi Arabia. Materials and Methods: A cross-sectional prospective study was carried out. Pretested well-designed questionnaires were distributed during the period from May to October 2014. Results: Parents of 1700 children out of 4000 have completed the questionnaire with a response rate of 42.5%, 1082 (63.6%) of them were male. Asthma prevalence among girls (14.4%) was higher than boys (12.4%), but this was insignificant. Asthma prevalence was significantly higher among Saudi participants (14.4%) than non-Saudi (5.9%). Nature of residency, the presence of a plant or presence of pets at home had no significant effect on asthma prevalence. A smoking of family member and a history of asthma in the family had an important association on asthma prevalence rate. The highest prevalence of asthma (29.7%) was among the younger children (<3 years). Symptoms of asthma enhanced during exercise. The positive association between asthma and both cough and breathlessness was noted. Asthma had no effect on schools absenteeism, visiting or admission to hospitals. Body mass index had no effect on the prevalence of asthma. Conclusion: The asthma prevalence rate among children was 13.1%, whereas smoking and a history of asthma in the family increased this rate. Future studies are recommended to investigate asthma prevalence based on clinical and laboratory diagnosis to explore the link between asthma and obesity.

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Background: Nurses are the key components of healthcare system and their knowledge is vital for improving the effectiveness of inhaler techniques. We aimed to study the baseline knowledge of nurses on obstructive airway diseases and inhaler techniques. Subjects and Methods: A descriptive study was performed among the practicing nurses (n = 24) in a Tertiary Care Teaching Hospital of Central Nepal. Information on demography, knowledge on obstructive airway diseases, and knowledge on inhaler techniques was assessed. Results: About 34% nurses mentioned the three common obstructive airway diseases. None of the nurses mentioned two tools used for measuring airway obstruction; however, 56.4% mentioned at least one correct tool. Majority (87.5%) of them thought that dry powder inhalers allow maximum deposition of drugs in the lung, but 70.8% were unaware of the steps of administration of drugs through inhaler/rotahaler. Conclusion: Practicing nurses had inadequate knowledge about obstructive airway diseases and inhaler techniques. There is urgent need of intervention to improve current knowledge and practice of nurses on obstructive airway disease and inhaler techniques.

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Background: Topics concerning preconception, prenatal health, and prenatal care-seeking behavior among Arab women have not been sufficiently addressed. This study focuses on these behaviors in Saudi pregnant women as they relate to birth outcomes. Aims: The aim of the study was to characterize preconception and prenatal health behavior concerning nutrition and physical activity and to identify health information sources that may impact their health literacy. Methods: A sample of 258 pregnant Saudi women recruited from two major hospital clinics in Riyadh were interviewed. Factors affecting folic acid (FA) awareness and consumption were examined individually using logistic regression to generate crude odds ratio (OR) and adjusted OR (AOR). Results: An overwhelming majority (>90%) is aware of significance of FA, however, less than half took supplements preconceptionally or consumed foods rich in FA. Younger (<30 years) women (AOR = 0.43; 95% confidence interval [CI] = 0.19, 0.98; P < 0.05) and women with lower education level (AOR = 0.36; 95% CI = 0.15, 0.89; P < 0.05) are less likely to have heard or known about the role of FA in preventing birth defects (AOR = 0.45; 95% CI = 0.23, 0.88; P < 0.05) and less likely to have knowledge of foods rich in FA (AOR = 0.57; 95% CI = 0.32, 1.0; P < 0.05) compared to college-educated women. Conclusion: The results suggest that awareness of folate importance is high, however, the consumption or supplementation of folate is low. The study findings highlight the need for routine preventative health care and educational opportunities for couples. In particular, younger women and women with lower educational level should be targeted for interventions.

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Background: The Eastern Province has the highest incidence of breast cancer in Saudi Arabia. The absence of an organized national education and screening program, combined with sociocultural factors, contributes to the presentation of advanced stages. Aim: This study was undertaken to assess the attitudes and practices of women in the Eastern Province toward screening mammography (SM) and breast self-examination (BSE). Subjects and Methods: A cross-sectional study was carried out using a structured questionnaire. Statistical Analysis: We used the Statistical Package for the Social Sciences. Double data entry procedures were used to assure quality and to detect errors in data entry. Frequency distributions were used to describe the data. Association between variables was evaluated by the Chi-square test, and a P≤ 0.05 was considered indicative of statistical significance. Results: A total of 611 females responded to the questionnaire. 12.4% reported having undergone mammography, 48.1% reported that they intended to do it in the future, while 12.7% reported having no intention to perform it. 43% reported performing BSE regularly. Sources of information about breast cancer and breast cancer screening included educational campaigns (27.8%) and media (27.8%). 75.2% of the respondents reported that their physician had no role in educating them about breast cancer screening. There was a significant relationship between the educational level of respondents and the practice of both BSE (P = 0.0001) and SM (P = 0.0000), as well as a significant association between the practice of mammography and having a relative diagnosed with cancer (P = 0.001). Conclusion: The results of our study revealed a low prevalence of breast cancer screening behaviors, 43% reported performing BSE, and only 12.4% had previously undergone SM. We strongly recommend that efforts must be carried out to increase the awareness of women.

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Background: Stroke, a cerebrovascular disease, is the second-most common cause of mortality worldwide while it ranks third among other causes of disability. The incidence of stroke in the Middle East is even higher than in developed countries. Despite the increasing disease burden, presently, there is only one established acute stroke unit at King Fahad Medical City in Riyadh, Saudi Arabia. Objective: The objective of the study is to assess the number of stroke patients admitted to different units in all hospitals across Riyadh city at one point of time. Materials and Methods: A cross-sectional survey was conducted in 30 hospitals distributed across Riyadh in 2016 and included newly diagnosed stroke patients. Data were extracted using case report forms depicting all patient data collected during admission to the specified hospital wards. Descriptive statistics were used to describe the quantitative and categorical variables. Results: Of the total of 30 hospitals invited to participate, only 3 (10%) hospitals agreed to participate. A total of 33 stroke patients were admitted to these hospitals, majority (27 [81.8%]) were admitted to internal medicine, 5 (15.2%) to surgery, and 1 (3%) to a neurosurgery unit. The prevalence of stroke among patients with age groups of 51–60, 61–70, and >80 years was higher in men than women. Conclusion: More epidemiological studies on stroke need to be conducted in different regions of the Middle East for effective planning and management. Further, other key areas to be improved include the development of wellequipped and trained health-care providers, collaboration of a multidisciplinary team, and raising public awareness.

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Intervertebral disc degenerative (IVDD) is a common orthopaedic condition characterized by a series of cellular, biochemical, structural and functional changes that imparts a large socioeconomic impact on healthcare system. Progressive loss of normal extracellular matrix constituents, namely proteoglycans and water content, is thought to be a key contributor to IVDD. The ability to sustain or augment normal matrix composition may slow down or reverse disc degeneration. Traditional concepts for treatment of lumbar disc degeneration have aimed at symptomatic relief by limiting motion in the lumbar spine, but novel treatment strategies involving direct injection of active substance, stem cells, growth factors and gene therapy have been attracting more attention in respect to prevent, slow or even reverse disc degeneration. Understanding the pathophysiological basis of disc degeneration will lay the foundation for the emergence of exciting new regenerative or reparative biological treatments for this debilitating condition either by inducing disc regeneration or replacing the degenerated disc.

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Background: Data on prevalence of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infections among pregnant women in non-institutionalized health facilities in Nigeria are missing. Aim: This study aimed at determining the prevalence and associated risk factors of HIV, HBV, and HCV infections among pregnant women receiving antenatal care in a traditional birth home in Nigeria. Setting and Design: This was a cross-sectional study conducted in a traditional birth home. Materials and Methods: Blood and sera samples obtained from 360 pregnant women were tested for the presence of HIV, HBV, and HCV antibodies and hemoglobin concentration determined using standard technique. Questionnaires were used to obtain demographic information. Statistical Analysis: INSTAT ^® statistical software. Results: The prevalence of HIV infection was significantly higher among pregnant women with no formal education and among those with multiple marriages (P = 0.008 and P = <0.0001 respectively). Only HIV infection was associated with anemia (OR = 4.154, 95% CI = 1.699, 10.157, P = 0.002). Age, gravidity, parity, marital status, history of blood transfusion, and educational status did not significantly affect the prevalence of HBV and HCV infections. Conclusions: The prevalence of HIV, HBV, and HCV infections were 7.2%, 2.2%, and 0.8%, respectively. Anemia was significantly associated with HIV infection only. Intervention effort at reducing HIV, HBV, and HCV infections and associated sequelae among pregnant women receiving antenatal care in traditional birth homes is strongly advocated.

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Context: Oral candidiasis is the most common oral opportunistic infection has seen in the immunocompromised patients. Apart from C. albicans the non-Candida albicans Candida species, which are less susceptible to the commonly used antifungal drugs are major etiological agent for candidiasis. Thus, the treatment strategy for candidiasis should be different in case of multiple species infection. Aims: The aim of this present study is to compare the antifungal susceptibility patterns of Candida species isolated from mono species and multiple species oral Candidal carriage. Materials and Methods: The species of Candida, isolated from mono and multiple species oral Candidal carriage of the healthy and immunocompromised patients were used for the experiment. Antifungal susceptibility test was performed by using disk diffusion susceptibility method on Methylene blue Glucose- Mueller-Hinton agar. Statistical Analysis Used: Paired student's t-test. Results: In this, present study, variability in antibiogram of Candida species isolated from mono species and the corresponding species isolated from multiple species combinations were reported. The susceptibility ranking for antifungal drugs for the strain isolated from mono species OPC (C. albicans > C.tropicalis > C. glabrata > C.krusei) and for the strains isolated from multiple species combination (C. albicans > C. glabrata > C.krusei > C.tropicalis) for mean of the five antifungal drugs combined were reported. Species of C. albicans and C. tropicalis were reported more resistant towards anti fungal agents when these present in mono-species condition, whereas; C. krusei and C. glabrata were more susceptible when these present in mono-species condition. Polyenes (amphotericin-B and nystatin) compounds were found to be most effective than azoles against Candida spp. isolated from multi-species lesions as none of the strain were shown resistant towards these drugs, conversely; a significant fraction of C. tropicalis and C. albicans isolated from mono-species lesion were shown resistant toward polyenes compound tested. Conclusions: The findings of this study shows statistically insignificant diverse antifungal susceptibility pattern of Candida species isolated from mono and multiple species Oropharyngeal Candidiasis combinations.

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