Prospective Evaluation of Side-Effects Following the First Dose of Oxford/AstraZeneca COVID-19 Vaccine among Healthcare Workers in Saudi Arabia

Background: Several different types of vaccines have been developed for the prevention of coronavirus disease (COVID-19). Despite several local and systemic side-effects to COVID-19 vaccination reported, the vaccines are still considered the best intervention to tackle the spread of the virus and reduce the severity of COVID-19 infection. However, the reported side-effects continue to have a crucial role in public confidence in the vaccine and its acceptance. This study aimed to investigate the short-term side-effects reported by the healthcare workers (HCWs) in Saudi Arabia after receiving the first dose of the Oxford/AstraZeneca (ChAdOx1 nCoV-19) COVID-19 vaccine. Methods: A prospective cohort study was conducted among HCWs in the Jazan region of southwestern Saudi Arabia. Healthcare workers who had received the first dose of the COVID-19 vaccine and agreed to participate in the study were followed up for 3 weeks post vaccination through a weekly online survey. Information was collected on local and/or systemic side-effects reported following vaccine administration. Participants’ general and demographic information was also collected. Results: A total of 57.2% (250/437) of the HCWs who participated in this study reported at least one side-effect. Injection site pain and redness (80.0%), fever (73.2%), whole-body pain/fatigue (56.4%), and headache (48.8%) were the most commonly reported side-effects. Moreover, 12.4% of the participants who reported side-effects needed to see a physician, and only one female participant was admitted to the hospital. Multivariate regression analyses revealed that nationality (Saudi, adjusted odds ratio (aOR) = 3.65; 95% CI = 2.40, 5.55) and residency (Jazan governorate, aOR = 0.38; 95% CI = 0.15, 0.95) were the significant factors associated with reporting COVID-19 post-vaccination side-effects, while the number of reported side-effects was found to be significantly influenced by occupation (medical, aOR = 0.42; 95% CI = 0.26, 0.66; p < 0.001) and gender (female, aOR = 0.61; 95% CI = 0.38, 0.97; p = 0.038). Conclusions: Findings of the present study support the safety of the Oxford/AstraZeneca COVID-19 vaccine among HCWs in Saudi Arabia. All the reported side-effects were mild-to-moderate side-effects. The findings may help convince vaccine-hesitant individuals and skeptics to accept the COVID-19 vaccine

The Appropriateness of Empirical Antimicrobial Treatment of Uncomplicated Urinary Tract Infection in Adult Female Patients in Jazan Region, Saudi Arabia

Introduction: Uncomplicated urinary tract infection (uUTI) is one of the most prevalent bacterial infections in clinical practice. Empirical treatment is used commonly; thus, knowledge of the local antimicrobial susceptibility pattern is crucial to avoid the growing antibiotic resistance. Purpose: The aim of this study is to evaluate the effectiveness of the empirical treatment of uUTI and determine the susceptibility pattern for common uUTI causative microorganisms at outpatient clinics in hospitals in the Jazan region. Method: This is a prospective observational study of 120 patients with uncomplicated urinary tract infections attending internal medicine outpatient clinics in Al-Hayat Jazan hospital, Saudi Arabia, from September 2021 to January 2023. Results: In total, 120 patients were included in the study. The mean age of the participants was 48.53 ± 9.29. Risk factors for UTI were found in 57.5%, and type 2 diabetes mellitus (DM) was the major risk factor (27.5%). The most common causative microorganism was Escherichia coli (E. coli) (87.5%), followed by Klebsiella pneumoniae (5%), Staphylococcus aureus, Enterobacter spp., and Enterococcus spp. (2.5%). Nitrofurantoin was the most effective antimicrobial agent (sensitivity rate of 91.7%) against all microorganisms, followed by Ciprofloxacin (75%). Conclusions: This study concluded that nitrofurantoin and Ciprofloxacin are suitable empirical treatments for uncomplicated urinary tract infection in the Jazan region, and increased resistance against trimethoprim/sulphamethoxazole (TMPSMX) and cefaclor was observed; thus, empirical therapy with these agents should be reconsidered in local guidelines. Wide surveillance research is necessary to monitor effective empirical therapies and to evaluate the regional antimicrobial susceptibility pattern

Assessment of sleep quality and its predictors among patients with diabetes in Jazan, Saudi Arabia

Abdulaziz Darraj,1 Mohamed Salih Mahfouz,2 Abdullah Alsabaani,3 Mubarack Sani,2 Anwar Alameer1 1Jazan Health Affairs, Ministry of Health, Jazan, Saudi Arabia; 2Family and Community Medicine Department, College of Medicine, Jazan University, Jazan, Saudi Arabia; 3Family and Community Medicine Department, College of Medicine, King Khalid University, Abha, Saudi Arabia Background: Poor sleep quality is common among patients with diabetes. It is associated with negative physical, psychological, and functional consequences. However, the implicated risk factors of poor sleep quality remain uncertain.Objectives: This study aimed to determine the prevalence of poor sleep quality among patients with diabetes and to investigate the factors associated with the poor sleep quality.Patients and methods: An analytical cross-sectional study of 307 diabetic patients in Jazan, Saudi Arabia was conducted in 2018. A multistage cluster random sampling was used to select the study participants. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Data on patient’s characteristics were gathered via patients’ interviews, and medical data were collected based on the patients’ files. Logistic regression analysis was used to identify the predictors of poor sleep quality.Results: The mean score of PSQI was 5.29±2.73. The prevalence of poor sleep quality was 55.4% (95% CI 49.7–60.8). Sociodemographic and clinical factors were significantly associated with poor sleep quality, such as being elderly, female, illiterate, smoker, complications of diabetes, comorbidity, or psychological symptoms. However, female gender was the strongest predictor of reporting poor quality of sleep, OR= 3.69, 95% CI 1.65–8.28 (P<0.001).Conclusion: Poor sleep quality among diabetic patients is a prevalent health problem. Many factors can affect sleep quality. Health care providers may consider routine screening for and address sleep problems among diabetic patients. Keywords: poor sleep quality, prevalence, risk factors, diabetes mellitus, Saudi Arabi

Rapid CD4 decline prior to antiretroviral therapy predicts subsequent failure to reconstitute despite HIV viral suppression

HIV-1 infection is characterized by loss of CD4 T cells, leading to immunodeficiency. Initiation of antiretroviral therapy (ART) results in suppression of the viral load and increased CD4 counts. Both viral and host factors determine CD4 cell responses to ART with approximately 15–30% of individuals having suboptimal increase of CD4 T cell count, most commonly due to lack of compliance to ART. A smaller fraction of patients will have immune reconstitution failure and suboptimal CD4 increase despite suppression of HIV replication, and these individuals are at risk for adverse health outcomes. We sought to characterize the factors associated with decreased immunological response among Manitoba’s HIV patient population.This retrospective case-control study included HIV patients with immune reconstitution failure despite suppression of HIV replication by ART. The immune reconstitution failure was defined by CD4 cell count increase from baseline of less than 100 CD4 cells/mm3 or lack of increase to above 200 CD4 cells/mm3 within one year of viral load suppression. Age and nadir CD4 cell counts are known risk factors associated with immune reconstitution failure. We chose controls (Patients with immune reconstitution success) of similar age and CD4 nadir cell with cases (Patients with immune reconstitution failure). We explored the potential effects of gender, HLA type, presence of co-infection, ethnicity, ART type, and rate of pre-treatment CD4 decline among cases and controls. Of more than 550 patients followed by our HIV clinic, 42 individuals met our definition of immune reconstitution failure and they were assigned to the cases group. 31 patients, comprising a range of ages and CD4 nadirs similar to those of the cases, were assigned to the control group. Our primary analysis was a regression model, predicting post-ART change in CD4 over time.After controlling for age and nadir CD4 cell counts, the only potential predictor that appears consistently associated with the rate of post-ART rise in CD4 over time in our cohort, regardless of the other variables that we have controlled for, is the rate of decline in CD4 pre-ART initiation.Several factors have been variably correlated with immune reconstitution failure of CD4 T cell count. Age and low CD4 nadir are factors previously shown to correlate with immune reconstitution failure; and we have controlled for them in our study. Another possible predictor is the rate of decline in CD4 pre-ART, which can serve as an additional marker of reconstitution failure and necessitate prioritizing individuals to ART initiation or identification of a subset of individuals that may be targeted for future adjunct strategies to improve immune recovery. Keywords: HIV, CD4, Immune reconstitution, Virologic suppressio

Prevalence and risk factors of multidrug-resistant tuberculosis in Jazan, Saudi Arabia

Background Drug-resistant tuberculosis (DR-TB) is a global challenge. Owing to its high annual mortality and morbidity rates, as stated in the annual global TB reports provided by WHO, the prevalence of multidrug-resistant tuberculosis (MDR-TB) or rifampicin-resistant tuberculosis was shown to be increasing worldwide in 2021. Patients with tuberculosis from 2018 to 2022 represented ~40 million individuals, including 1.5 million with DR-TB. The study’s goal was to identify MDR-TB prevalence and risk factors in Jazan, Saudi Arabia. Patients and methods The research was done on 114 patients diagnosed with pulmonary TB in Jazan Chest Hospital from January to April, 2019. Demographic data were collected. Monteux test, chest radiograph, sputum smear, and Lowenstein–Jensen culture were performed for all patients with pulmonary TB. Patients were allocated in either group A, with 103 (90.4%) patients, if they had Mycobacterium tuberculosis-susceptible isolates, or in group B, with 11 (9.7%) patients, if they had M. tuberculosis-resistant isolates. Results The observed overall DR-TB prevalence was 9.7%. The proportion of MDR isolates was 7%, polyresistant isolate TB was 0.9%, rifampicin-resistant tuberculosis was 0.9%, and ethambutol-resistant TB was 0.9%. Females were more in group B (54.5%) than in group A (26.2%). Unmarried patients were higher in group A (60.2%) than in group B (29.3%). Comorbidities had significant values in the drug-resistant groups (90.9%). Conclusion The study showed that screening and treatment of DR-TB are crucial for the control of TB in Jazan and Saudi Arabia as a whole

Natural and synthetic drugs and formulations for intravaginal HPV clearance

Background: Except for a few preventative Human Papillomavirus (HPV) vaccines, there is currently no cure for HPV infection. There are a number of cutting-edge strategies and potent medications or herbal formulations that can be applied topically for early clearance of HPV infection before HPV DNA gets integrated into host cell genome. This is facilitated due to cervical cancer having distinct and well-recognized long precancerous stages. Objectives: This review aims to outline every possible medication and formulation, both natural and synthetic, that can be applied topically as intravaginal application to help remove HPV infection at an early precancerous stage. Results: Several anti-HPV/HPV clearance compounds and formulations for high-grade lesions are undergoing clinical trials. However, the majority of compounds are still in the early stages of development and require additional research to become viable HPV clearance candidates. Synthetic drugs may be more promising because they may have a more targeted effect; however, they may also have significant adverse effects. On the other hand, natural medications are safer to use. They are less specific, but have minimal to no adverse effects. Conclusions: This article may serve as a valuable resource of information for managing and preventing precancerous carcinogenic HPV infections. Research could be directed toward developing candidate drugs to make evidence-based decisions about advancing them to clinical trials and, eventually, to the market for potential use in the prevention and control of cervical cancer, which is almost always preventable or even curable if detected early

Human Papillomavirus Knowledge and Vaccine Acceptability in Jazan Province, Saudi Arabia

Background: Human Papillomavirus (HPV) is the most common sexually transmitted infection that affects teens and adults in their early 20 s. Screening and HPV vaccination are important preventive measures to reduce cases of HPV and associated complications. Studies about HPV knowledge and vaccine acceptability are scarce in Saudi Arabia. This study evaluated participants’ knowledge, attitude, and acceptability concerning HPV and the HPV vaccine in Jazan Province, Saudi Arabia. Methods: A cross-sectional study was conducted using a pretested survey that assessed knowledge and attitude toward HPV and the HPV vaccine among the population of Jazan Province, Saudi Arabia. Responses were collected from adults between January and March 2022. Data were analyzed using a t-test and chi-square test. Results: We included 569 in the study. Most participants were single (65%), females (83%), with a university-level of education (78%). The recorded knowledge score for all participants was 1.99 (out of 10). About half of the participants denied that HPV is a common sexually transmitted infection. Further, 53% were interested in the HPV vaccine, and 63% of participants acknowledged that the HPV vaccine could prevent warts and cervical cancer. About 30% of the participants opposed the vaccine due to religious reasons. Conclusion: The results of our study highlight the inadequate level of knowledge concerning HPV infection, even among highly educated people. Thus, by promoting the HPV vaccine acceptance and use, awareness can be raised in our community to assure better knowledge and achieve higher protection from this virus and its complications

Admission Grades as Predictors of Medical Students’ Academic Performance: A Cross-Sectional Study from Saudi Arabia

Background: Admission to medical school is competitive, and different countries use various tests in addition to high school grades to minimize selection bias. A few studies have been conducted to evaluate the usefulness of these tests as predictors for students’ academic performance. In this article, we aimed to assess factors that influenced students’ grades in medical school. Methods: A cross-sectional study included all students who graduated from the Faculty of Medicine at Jazan University between 2018 and 2020. Scores of the included participants were extracted from the registry of Jazan University, and additional questions about study habits were completed by the included students. Descriptive, univariate, and multivariate analyses were performed for the factors that impacted academic performance. Results: There were 331 included candidates, and the majority of them were female (53%). About 60% of the participants were medical residents at the time of the study, and 40% were interns. Univariate and multivariate analyses indicated that grades in high school and the pre-requisite tests were positively associated with students’ academic performance. Further, studying more than two hours per day was positively correlated with better grades in medical school. Conclusion: Scores of the admission tests can serve as predictors for student performance in medical school. National studies are deemed essential to evaluate additional admission tests for medical school, an action that would minimize selection bias