Muhammad Anwar Khan

This study assessed the awareness and knowledge of Saudi health sciences students regarding epigenetics and its impact on the brain and behavior.

Background: Dry eye disease (DED) is a multifactorial disease. Numerous risk factors might cause DED, including indoor air pollution, such as incense. Incense (Bakhoor) is widely used in many cultures, including Saudi Arabia, although its smoke contains toxic chemicals that pose serious health hazards. This research investigates the link between the Schirmer II test and tear fluid proteins in DED patients. The study focuses on identifying the ocular examinations, hypothesizing that incense smoke, particularly from synthetic types, exacerbates DED. Methods: This pilot cross-sectional study was conducted at King Abdulaziz Medical City (KAMC) in Jeddah, Saudi Arabia. Participants were recruited from the Cornea and Ophthalmology Clinics. Eye assessments analyzed tear protein concentrations, including tear collection using Schirmer II test strips and tear break-up time (TBUT). The study included DED patients who used incense. Tear fluid from the Schirmer test of 20 randomly selected patients was used for protein analysis of total protein, lactoferrin, and Immunoglobulin E. Inclusion criteria were male and female subjects aged 18 years or older, diagnosed with DED, and using incense. The sample size was 55 participants, selected via convenience sampling. Subjective data were collected through questionnaires, as well as objective data from the tear test and the sample and analyzed with SPSS. Descriptive and inferential statistics were used, with statistical significance set at p-value < 0.05. Results: The Ocular Comfort Index (OCI) categories showed that 21.8% had no symptoms, 40.0% had low symptoms, 30.9% had moderate symptoms, and 7.3% reported high symptoms. TBUT values and Schirmer test scores decreased with increasing OCI severity, with no statistical significance. The mean (SD) of total protein in the right and left eyes for high OCI was 7.19 (1.39) and 7.42 (0.91), respectively, with no statistical significance. The immunoglobulin E levels in the right and left eyes for high OCI were 301.71 (55.97) and 301.71 (47.14), respectively, with no statistical significance. The mean (SD) of lactoferrin in the right and left eyes for high OCI was 163.77 (10.42) and 159.43 (1.68), respectively, with no statistical significance. Conclusions: The study findings demonstrate alignment in incense-using patients between subjective OCI symptom scores and objective clinical diagnostic measures. Specifically, higher OCI scores are associated with lower TBUT and Schirmer II test values, as well as changes in tear biomarkers such as IgE and lactoferrin. These findings emphasize the potential of using simple screening methods combined with bioanalytical markers for early detection of ocular surface disease. This highlights the potential health risks associated with incense exposure, particularly for individuals predisposed to DED. The urgency for further research to explore the long-term effects of incense on ocular health and to raise awareness about its potential impact on populations with high incense usage cannot be overstated.

Snoring is a sound produced by the vibrations of upper airway soft tissues due to partial airway obstruction during sleep. It is often linked to sleep-disordered breathing and may suggest underlying conditions such as obstructive sleep apnea. As future healthcare professionals, health sciences students should possess adequate knowledge and appropriate attitudes regarding snoring and its clinical implications. This study aimed to assess health sciences students’ knowledge and attitudes toward snoring. A descriptive cross-sectional study was conducted among 760 health sciences students from three universities in Jeddah, Saudi Arabia. Participants were recruited using quota sampling and completed a validated, self-administered questionnaire assessing demographic characteristics, knowledge, and attitudes regarding snoring. Data were analyzed using descriptive statistics and inferential tests. Independent t-tests and one-way ANOVA were used to compare mean scores between groups, with statistical significance set at p < 0.05. Likert-scale responses were coded from 1 to 5, and mean scores were calculated. Given the large sample size, Likert responses were treated as approximately continuous variables and analyzed using parametric tests. Most participants reported that snoring disrupts sleep (75.5%) and is more common among males (73.3%). Female students demonstrated significantly greater agreement that snoring can worsen nasal symptoms (p = 0.005). Differences in knowledge and attitudes were observed across academic disciplines, with students from the anesthesia technology program demonstrating a stronger understanding of several snoring-related concepts. Across all disciplines, most participants disagreed with the statement that continuous positive airway pressure (CPAP) increases snoring (p < 0.001). Health sciences students demonstrated varying levels of knowledge and attitudes toward snoring, with notable differences by gender and academic discipline. These findings highlighted the importance of incorporating targeted educational strategies within health sciences curricula to enhance awareness and support early recognition of snoring-related health conditions.

Aim: This study examines the impact of an educational initiative on healthcare providers' proficiency and attitudes toward genetic testing integration into psychiatric practices. Material and methods: A quasi-experimental design with a single group pre/posttest was employed. Convenience sampling was used to recruit 227 participants. Four valid and reliable tools were used to assess demographic characteristics, knowledge, attitudes, and challenges related to pharmacogenetic testing Results: Among the 227 participants, 36% were nurses, 17.7% were physicians, 17.7% were psychologists, 14.8% were pharmacists, and 5.4% were social workers. Most participants had 1--5 years of experience and lacked prior education or workshop attendance related to genetic testing. Most agreed that genetic testing is unused in psychiatric diagnosis but acknowledged its crucial role in guiding medication selection, dosage, and personalized treatment. After the educational program, significant improvements in participants' knowledge and attitudes toward genetic testing were observed. Conclusions: The educational program effectively enhanced healthcare providers' knowledge and attitudes regarding integrating genetic testing into psychiatric practice. Substantial improvements between pre- and posttest scores indicate increased proficiency in addressing challenges related to genetic testing. The findings reveal a significant knowledge gap, as many participants lacked prior education on genetic testing during their undergraduate studies. This underscores the need for ongoing training and support. Encouraging collaboration between genetic specialists and psychiatric practitioners and ensuring adequate resources are essential for successfully implementing genetic testing in routine psychiatric care.

Introduction: Extreme preterm infants (EPI), born at p = 0.009). Antenatal corticosteroid (ACS) (a OR 2.9, 95% CI 1.05–8.04, p = 0.049) and cesarean delivery (aOR 2.88, 95% CI 1.03–8.07, p = 0.044) were independently associated with increased odds of survival. Early hypotension (aOR 0.28, 95% CI 0.12–0.67, p = 0.004) and severe IVH (aOR 0.39, 95% CI 0.16–0.94, p = 0.035) were significantly associated with increased mortality. The incidence of severe IVH declined from 46% to 26% over the study period, while rates of PVL and surgical NEC showed downward trends. BPD (51%) and severe ROP (19%) remained relatively unchanged. Conclusions: Over nearly two decades, survival among extreme preterm infants of birth weight <750 g ang gestational age <26 weeks improved significantly. ACS administration and cesarean birth were associated with an increased rate of survival. Early hypotension and severe IVH were predictors of mortality. Severe IVH, PVL, and surgical NEC declined during the last period. Ongoing advances in perinatal care and targeted neonatal interventions are essential to further improve outcomes in this high-risk population.

Introduction: Bloodstream infection (BSI) is a major contributor to morbidity and mortality in hemodialysis patients. Our objective was to identify pathogens causing BSI, its incidence, and associated risk factors. Methodology: Retrospective positive blood culture data were analyzed from five hemodialysis centers (January 2019 until December 2023) across Saudi Arabia. Results: There were 437 bacteremia episodes in 432 patients, with 405 central line and 367 peripheral samples. The BSI rate was 0.67 per 100 patient months. 375 (85.8%) patients had a Central Venous Catheter (CVC), 27 (6.17%) had an arteriovenous fistula (AVF), 5 (1.14%) had an arteriovenous graft (AVG), and 30 (6.9%) had dual access. The central line-associated bloodstream infection (CLABSI) rate was 1.41 per 100 patient months. Gram-positive organisms in the central line blood culture were 169 (44%), and Gram-negative were 200 (51.81%); 16 (4%) cases were polymicrobial, and there was one case of fungi. In peripheral blood cultures, 158 (48.9%) were Gram-positive and 150 (46.4%) were Gram-negative. The most common pathogens were Staphylococcus aureus, MRSA, and Staphylococcus epidermidis in Gram-positive organisms, and Enterobacter cloacae, Klebsiella pneumoniae, and Pseudomonas aeruginosa in Gram-negative organisms. Three cases of fungal infection occurred during the study period. Two-thirds of patients (68%) required hospital treatment, and in 54% of the cases, there was loss of vascular access. Mortality due to sepsis within 4 weeks occurred in five patients. Conclusions: The risk of BSI in hemodialysis patients is high. Gram-negative pathogens contribute to half of the events. In Saudi Arabia, Gram-negative pathogen incidence is significant, and measures are required to curtail it.

Background: Type 2 Diabetes Mellitus (T2DM) patients are 50-60% more likely to develop Alzheimer’s Disease (AD). T2DM has many risk factors, including inflammation. Previous studies suggest that CRP was higher in diabetic patients, indicating that it may play a role in diabetogenesis and insulin resistance. Many diseases are prevalent in older age, including T2DM and AD. Moreover, multiple studies suggested a possible association between vitamin A levels, AD, and T2DM. However, the role of Vitamin A in Alzheimer's patients with T2DM has not yet been fully investigated. Therefore, this study aims to measure the association between dietary vitamin A deficiency and AD patients with T2DM in King Abdulaziz Medical City, Jeddah, Western Region, Saudi Arabia, to help expand the preexisting knowledge of the diagnostic risk factors of both the diseases and to determine the significance of vitamin A as a nutritional factor in their management and prevention. Methods: This case-control study investigates the prevalence of vitamin A deficiency (VAD) among Alzheimer's disease (AD) patients with and without type 2 diabetes mellitus (T2DM). Participants included 103 AD patients aged 40 and older from the National Guard Hospital in Saudi Arabia, recruited between 2016 and 2022. Data collection occurred in two phases: first, through a review of medical records to gather demographic and health history information, including retrospective blood tests for systemic C-reactive protein (CRP) levels and comorbidities; second, using the HKI Food Frequency Questionnaire (FFQ) to assess dietary intake of vitamin A-rich foods over the past week, with caregiver interviews facilitating this process. Each subject was also prospectively interviewed to assess the presence of VAD events. The study aims to elucidate the relationship between dietary habits and VAD prevalence in AD patients, contributing to the understanding of nutritional impacts on cognitive health in this population. Results: This study examined demographic and clinical characteristics of the Alzheimer’s group, with 70.1% having both Alzheimer's with T2DM and 29.9% having Alzheimer's alone. Significant differences in age were found (p-value = 0.03), but gender distribution was similar (p-value = 0.45). Most caregivers were sons, and 81.43% of patients received oral feeding. Comorbidities included hypertension (94.90%) and dyslipidemia (63.4%), with significant differences (p-value < 0.001). Correlation analyses showed weak negative correlations between CRP and vitamin A concentrations in both groups (Alzheimer with T2DM: p-value = 0.713, rho = -0.064; AD only: p-value = 0.223, rho = -0.121). Age and vitamin A levels also exhibited weak correlations: Alzheimer’s with 2DM (p-value = 0.727, rho = 0.053) and Alzheimer’s only (p-value = 0.223, rho = -0.253), neither of them was statistically significant. Symptoms of vitamin A deficiency were noted in Alzheimer's patients with T2DM, with no significant differences between groups. Dietary intake was lower for vitamin B complex, vitamin D, and multivitamins in AD patients with T2DM. Conclusion: The findings highlight the need for further investigation into the factors influencing vitamin A metabolism in these populations. Additionally, the prevalence of vitamin A deficiency symptoms and low dietary intake of essential nutrients among patients with Alzheimer's with T2DM suggests critical areas for nutritional intervention. Addressing these deficits may improve patient outcomes and enhance overall care strategies for individuals living with Alzheimer's disease.

Background: Despite efforts to rely on arteriovenous fistulas/grafts for maintenance hemodialysis, a significant number of patients still depend on tunnel hemodialysis catheters for treatment. This poses a risk factor for central line-associated bloodstream infection (CLABSI) and, subsequently, vascular access compromise. Method: We conducted a retrospective study in five dialysis centers to determine the potential factors resulting in vascular access loss, CLABSI incidence, and microbe distribution patterns in Saudi Arabia at centers under the Ministry of National Guard Health Affairs. Adults who regularly received hemodialysis and had positive blood cultures between January 2019 and December 2023 were the subjects of the study. Results: Our study identified the presence of tunnel infection (p < 0.001), the presence of a Gram-negative pathogen (p = 0.036), and a high body mass index (BMI > 30) (p = 0.04) as potential risk factors leading to the loss of tunnel central venous catheters. In contrast, there was a lower probability of central venous catheter loss due to Gram-positive pathogens (p = 0.01). The CLABSI rate was 1.55 per 100 patients per month over a five-year period. Patients with CVC required more hospital treatment and had a significantly higher rate of vascular access loss (p < 0.001). Both central and peripheral blood cultures had nearly identical microbe spectra. Methicillin-sensitive Staphylococcus aureus (MSSA), Methicillin-resistant Staphylococcus aureus (MRSA), and Staphylococcus epidermidis had the highest prevalence rates among Gram-positive organisms. Among the Gram-negative bacteria, Enterobacter cloacae was the most common, followed by Klebsiella pneumonia and Pseudomonas aeruginosa. Conclusions: Our findings indicate the need for rigorous measures and interventions to prevent Gram-negative infections and decrease the reliance on central venous catheters, to decrease infections in hemodialysis patients, and decrease morbidity and cost. Strict hand hygiene, patient education, and surveillance programs are recommended to monitor these patients.

Background: Erectile dysfunction (ED) is a prevalent complication among diabetic men, impacting their quality of life and overall health outcomes. Both glycemic control and body mass index (BMI) have been implicated as potential risk factors for ED in this population, but the evidence remains inconclusive, particularly in the context of Saudi Arabia. Study Aim: This meta-analysis aimed to systematically evaluate the association between glycemic control, BMI, and the prevalence of ED among diabetic Saudi men. Methods: A comprehensive literature search was conducted in major electronic databases to identify relevant studies published up to 31 December 2023. Eligible studies were cross-sectional or prospective in design, included male participants diagnosed with diabetes mellitus, and reported data on glycemic control, BMI, and ED prevalence. Data were extracted, and a random-effects model was used to calculate pooled odds ratios (ORs) with 95% confidence intervals (CIs). Heterogeneity was assessed using the I ² statistic, and publication bias was evaluated using funnel plots. Results: Five studies met the inclusion criteria, comprising a total sample of 1710 diabetic Saudi men. The pooled analysis revealed a significant association between uncontrolled diabetes mellitus and increased risk of ED (OR = 3.01, 95% CI: 0.98–9.26), with substantial heterogeneity ( I ² = 92%). However, no significant association was found between high BMI (overweight or obese) and ED prevalence (OR = 0.73, 95% CI: 0.34–1.56), with high heterogeneity ( I ² = 85%). Funnel plots suggested minimal publication bias. Conclusion: Our findings highlight the critical role of glycemic control in determining ED risk among diabetic Saudi men. While uncontrolled diabetes appears to significantly increase the likelihood of ED, BMI alone may not be a strong predictor in this population. Clinicians should prioritize aggressive management of diabetes to mitigate ED risk, while individualized approaches to weight management may be warranted for overall health optimization.