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Artificial intelligence is dramatically transforming medical imaging. In Saudi Arabia, there are a lack of studies assessing the level of artificial intelligence use and reliably determining the perceived impact of artificial intelligence on the radiology workflow and the profession. We assessed the levels of artificial intelligence use among radiology trainees and correlated the perceived impact of artificial intelligence on the workflow and profession with the behavioral intention to use artificial intelligence. This cross-sectional study enrolled radiology trainees from Saudi Arabia, and a 5-part-structured questionnaire was disseminated. The items concerning the perceived impact of artificial intelligence on the radiology workflow conformed to the six-step standard workflow in radiology, which includes ordering and scheduling, protocoling and acquisition, image interpretation, reporting, communication, and billing. We included 98 participants. Few used artificial intelligence in routine practice (7%). The perceived impact of artificial intelligence on the radiology workflow was at a considerable level in all radiology workflow steps (range, 3.64–3.97 out of 5). Behavioral intention to use artificial intelligence was linearly correlated with the perceptions of its impact on the radiology workflow and on the profession (p < 0.001). Artificial intelligence is used at a low level in radiology. The perceived impact of artificial intelligence on radiology workflow and the profession is correlated to an increase in behavioral intention to use artificial intelligence. Thus, increasing awareness about the positive impact of artificial intelligence can improve its adoption.

Objectives: Among medical students, depression, anxiety, and stress (DAS) are key public wellbeing challenges that require epidemiological research. We aimed to evaluate potential sources of these psychological disturbances and assess the contribution of academic and non-academic life stressors in psychological morbidity among medical students. Methods: This exploratory questionnaire-based survey was conducted in a Saudi Arabian public sector medical college. A total of 231 medical students were enrolled and completed the depression, anxiety, and stress scale-21 (DASS-21) questionnaire. Results: More than half of the medical students, 129 (55.8%), had depression, 106 (45.9%) students had anxiety, and 87 (37.7%) students had stress. Academic achievement was the largest explanatory factor for depression and stress, whereas bodily appearance constituted the largest explanatory factor of anxiety among the study sample. Academic and non-academic stressors score was significantly associated with depression (adjusted Odds Ratio, aOR = 1.13, 95% CI 1.07–1.19), anxiety (aOR = 1.07, 95% CI 1.03–1.12), and stress (aOR = 1.12, 95% CI 1.08–1.17). Conclusions: Medical students have a high incidence of negative emotional states. These negative psychological states were explained by academic achievement and bodily appearance. The studied stressors influenced medical students' psychological wellbeing.

To explore preferences of the patients attending King Abdulaziz Medical City (KAMC), Jeddah, Saudi Arabia, in their treating physicians and to determine demographic and personal factors influencing their preferences. Through a cross sectional design, 366 patients attending KAMC were systematically selected, and were requested to a pre-designed valid questionnaire. The study conducted between November 2017 and January 2018. The Statistical Package for Social Sciences was used for statistical analysis which included independent sample t-test, ANOVA and Pearson correlation. A p-value less than 0.05 was considered significant. The study showed that females were significantly more preferring to get information, careful examination and receiving attention. Older respondents were interested in nding out how serious is their problem and having enough time for talking about their condition. Higher income respondents focused on necessity of physician caring for their personal situation. Highly educated individuals were concerned about getting enough information, and patients with chronic diseases were much interested by the truth of their condition. Each dimension of the personality traits was significantly correlated with different package of preferences in their treating physician. Respondents' preferences in their treating physician are significantly influenced by their demographic characteristics as well as their personality traits. It is highly recommended that physicians, generally, should be attentive listener, informative while discussion, maintaining eye contact and showing interest and empathy for adult middle-aged patient. Also, to consider other preferable features based on patients' demographics and personalities.

Objectives: To describe variations in characteristics of randomized controlled trials conducted in the Gulf Cooperation Council (GCC) countries, and critically appraising the quality of design, conduct and analysis of the trials. Methods: We carried out a systematically comprehensive electronic search of articles published between 1990 and 2018 and indexed in several databases: i) MEDLINE/ PubMed, ii) EMBASE, iii) Cochrane Central Register of Controlled Trials (CENTRAL), iv) ClinicalTrials.gov, and v) World Health Organization International Clinical Trials Registry Platform. We summarized the overall risk of bias present in all analyzed studies using the Cochrane Collaboration risk of bias tool (CCRBT). Results: A remarkable shift in numbers of publications from 2006 onwards was found. The largest number of publications were from Saudi Arabia and consisted of hospitals/clinics based studies. Lack of randomization was found in the majority of reports, and nearly three-fourth of the studies involved the use of intention-to-treat (ITT) principle. However, the proportion of adequately generated random sequence methods has increased yearly, and this increase accounted for a relatively large proportion over the latter half of the studied period (p<0.001), in contrast to the proportion of allocation concealment and blinding. Journal impact factor was significantly correlated with the quality of random sequence generation (r=0.145; p=0.014). Conclusion: The randomization methods have gained more attention over the last 3 decades. Secondly, Journal impact factor can serve as an indicator of randomization quality. To mitigate the large rate of overall high risk of bias in GCC studies, high-quality trials must be considered by ensuring adequate allocation concealment and blinding methods. PROSPERO No. ID: CRD42022310331 Keywords: Clinical Trial, systematic review, bias, Arab world [phrase omitted]

Objectives:To describe variations in characteristics of randomized controlled trials conducted in the Gulf Cooperation Council (GCC) countries, and critically appraising the quality of design, conduct and analysis of the trials.Methods:We carried out a systematically comprehensive electronic search of articles published between 1990 and 2018 and indexed in several databases: i) MEDLINE/PubMed, ii) EMBASE, iii) Cochrane Central Register of Controlled Trials (CENTRAL), iv) ClinicalTrials.gov, and v) World Health Organization International Clinical Trials Registry Platform. We summarized the overall risk of bias present in all analyzed studies using the Cochrane Collaboration risk of bias tool (CCRBT).Results:A remarkable shift in numbers of publications from 2006 onwards was found. The largest number of publications were from Saudi Arabia and consisted of hospitals/clinics based studies. Lack of randomization was found in the majority of reports, and nearly three-fourth of the studies involved the use of intention-to-treat (ITT) principle. However, the proportion of adequately generated random sequence methods has increased yearly, and this increase accounted for a relatively large proportion over the latter half of the studied period (p<0.001), in contrast to the proportion of allocation concealment and blinding. Journal impact factor was significantly correlated with the quality of random sequence generation (r=0.145; p=0.014).Conclusion:The randomization methods have gained more attention over the last 3 decades. Secondly, Journal impact factor can serve as an indicator of randomization quality. To mitigate the large rate of overall high risk of bias in GCC studies, high-quality trials must be considered by ensuring adequate allocation concealment and blinding methods. PROSPERO No. ID: CRD42022310331

Objectives Among medical students, depression, anxiety, and stress (DAS) are key public wellbeing challenges that require epidemiological research. We aimed to evaluate potential sources of these psychological disturbances and assess the contribution of academic and non-academic life stressors in psychological morbidity among medical students. Methods This exploratory questionnaire-based survey was conducted in a Saudi Arabian public sector medical college. A total of 231 medical students were enrolled and completed the depression, anxiety, and stress scale-21 (DASS-21) questionnaire. Results More than half of the medical students, 129 (55.8%), had depression, 106 (45.9%) students had anxiety, and 87 (37.7%) students had stress. Academic achievement was the largest explanatory factor for depression and stress, whereas bodily appearance constituted the largest explanatory factor of anxiety among the study sample. Academic and non-academic stressors score was significantly associated with depression (adjusted Odds Ratio, aOR = 1.13, 95% CI 1.07–1.19), anxiety (aOR = 1.07, 95% CI 1.03–1.12), and stress (aOR = 1.12, 95% CI 1.08–1.17). Conclusions Medical students have a high incidence of negative emotional states. These negative psychological states were explained by academic achievement and bodily appearance. The studied stressors influenced medical students' psychological wellbeing.

This study aims to assess effective radiation doses (EDs) for pediatric computed tomography (CT) procedures in Madinah (single hospital), Saudi Arabia, and propose diagnostic reference levels (DRLs) for these procedures. This retrospective study collected data from 600 pediatric patients who underwent five CT procedures. The data were categorized by the type of CT procedure and the age of the patients. EDs and proposed DRLs for the pediatric CT procedures were computed. The highest EDs were found for abdominal (6.3 mSv) and head (4.8 mSv) CT procedures in pediatric patients aged <1 year. DRLs of the CTDIvol and DLP for abdominal and head CT procedures in pediatric patients aged <1 year were 4.2 mGy, 94 mGy.cm and 25 mGy, 414 mGy.cm, respectively. Chest EDs had the lowest EDs among all pediatric CT procedures, with EDs of 1.93, 1.51, 1.91, and 2.05 mSv in patients aged <1, 1 ≤ to < 5, 5 ≤ to < 10, and 10 ≤ to ≤ 15 years, respectively. It can be concluded that optimization is required for abdominal and head CT procedures in pediatric patients aged <1 year. Frequent updates on ED and DRL calculations will help monitor radiation doses and minimize radiation risks for patients undergoing these procedures.

Background The burden of carbapenem resistance is not well studied in the Middle East. We aimed to describe the molecular epidemiology and outcome of carbapenem-resistant Enterobacterales (CRE) infections from several Saudi Arabian Centers. Methods This is a multicenter prospective cohort study conducted over a 28-month period. Patients older than 14 years of age with a positive CRE Escherichia coli or Klebsiella pneumoniae culture and a clinically established infection were included in this study. Univariate and multivariable logistic models were constructed to assess the relationship between the outcome of 30-day all-cause mortality and possible continuous and categorical predictor variables. Results A total of 189 patients were included. The median patient age was 62.8 years and 54.0% were male. The most common CRE infections were nosocomial pneumonia (23.8%) and complicated urinary tract infection (23.8%) and 77 patients (40.7%) had CRE bacteremia. OXA-48 was the most prevalent gene (69.3%). While 100 patients (52.9%) had a clinical cure, 57 patients (30.2%) had died within 30 days and 23 patients (12.2%) relapsed. Univariate analysis to predict 30-day mortality revealed that the following variables are associated with mortality: older age, high Charlson comorbidity index, increased Pitt bacteremia score, nosocomial pneumonia, CRE bacteremia and diabetes mellitus. In multivariable analysis, CRE bacteremia remained as an independent predictor of 30 day all-cause mortality [AOR and 95% CI = 2.81(1.26–6.24), p = 0.01]. Conclusions These data highlight the molecular epidemiology and outcomes of CRE infection in Saudi Arabia and will inform future studies to address preventive and management interventions.

Background: HPV represents one of the most common sexually transmitted infections worldwide, with significant adverse clinical consequences such as cervical cancer. However, the knowledge and awareness regarding HPV and its vaccination, particularly among Saudi women, are still under debate. Our study aims to investigate the knowledge, awareness, and attitude toward HPV and its vaccines among women in the Medina region. Methods: A descriptive cross-sectional study was conducted from July 2024 to September 2024 in women aged more than 18 years and residing in Medina. The collected data included information regarding women’s demographics, knowledge, awareness, and attitudes toward HPV and its vaccination. All the statistical analyses were executed using SPSS. Results: A total of 721 participants enrolled in our study after adequate completion of the online questionnaire. The majority of the population (45.2%) is aged 18–25 years, with 51.3% of participants being single regarding marital status. A total of 59.4% of the participants have heard about HPV, 37% know that it is sexually transmitted, and 37.4% know about its ability to cause cervical cancer. Social media and the internet were the primary sources of information regarding the HPV vaccine, with 41.6% thinking that the HPV vaccine can be effective against HPV infection. Around 40% of the participants showed an attitude toward receiving the HPV vaccine as they feel they are at risk. The educational status and monthly income were notably associated with the overall knowledge and awareness regarding HPV and its vaccine. Conclusions: Our descriptive cross-sectional study highlights the significant gap in knowledge and awareness regarding HPV and its vaccine, with a lack of awareness identified as the commonest barrier preventing people from receiving the HPV vaccination. Hence, enhancing the knowledge and awareness level is essential to increase vaccination rates.

Post-stroke seizures present a global challenge, yet its frequency and factors associated with its incidence are poorly documented, particularly in the Middle East. Thus, this study aims to investigate post-stroke seizure frequency and stroke-associated factors among ischemic stroke patients in Saudi Arabia, addressing demographic, clinical, and comorbid aspects to improve prognosis, diagnosis, prevention, and management. A multicenter, cohort observational study included eligible ischemic stroke patients who were categorized into those who developed seizures after injury and those who did not. Additionally, the study assessed the association between post-stroke seizure and 12-month mortality, 12-month stroke recurrence, and the occurrence of hemorrhagic transformation (HT) within 30 days. The study involved 1235 ischemic stroke patients, in which 13.5% developed post-stroke seizures. Patients with post-stroke seizures had more extended hospital stays, higher intensive care unit (ICU) admission rates, and a higher prevalence of comorbidities. Factors independently associated with post-stroke seizures included previous stroke history (OR = 1.93; 1.35–2.75), ICU admission (OR = 1.7; 1.15–2.5), and depression (OR = 2.1; 1.38–3.30). Logistic regression revealed associations between post-stroke seizures and HT (OR = 2.61; 1.70-4.00), stroke recurrence (OR = 2.30; 1.58–3.36), and mortality (OR = 1.89; 1.33–2.68). However, after adjusting for covariates, post-stroke seizures were significantly associated with stroke recurrence only (aOR = 1.7; 1.11–2.63). Our study identifies notable associations and risk factors for post-stroke seizures in ischemic stroke patients. This underscores the importance of adopting a comprehensive approach to stroke care to enhance the prediction, prevention, and management of post-stroke seizures. Further research is warranted to validate these findings, enhance the understanding of post-stroke seizure mechanisms, and guide management strategies.