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Chronic rhinosinusitis with nasal polyposis (CRSwNP) occurs due to the inflammation of sinonasal tissue. Cases of CRSwNP more commonly demand revision endoscopic sinus surgery (ESS) as compared to patients without polyposis. The recurrence rate varies widely depending on various factors, such as the extent of surgery, patient compliance with postoperative care, and the severity of the underlying disease. Studies conducted on chronic rhinosinusitis (CRS) patients showing recurrence or relapse of nasal polyps post endoscopic sinus surgery were included. We used the modified Newcastle-Ottawa scale (NOS) for cross-sectional studies and cohort studies. Only 15 articles met our inclusion and exclusion criteria after the full-text screening. The studies enrolled participants between 2009 and 2022, including 2,515 ESS patients. The mean age of the included subjects ranged between 37.1 and 57.57 years. In conclusion, CRSwNP is a chronic inflammatory disease that can impose a significant burden on patients, healthcare systems, and society. Asthma, aspirin intolerance, peripheral eosinophilia, interleukin-5 (IL-5) expression, T2 profile, and intense sinus opacification have been noted to be independent predictors of the condition in different studies. Recurrent polyposis in CRS signals a more aggressive disease course, requiring close follow-up and revision surgeries in the long run.

Primary Angle Closure Glaucoma (PACG), is caused by narrowing the iridocorneal angle and increases the risk of blockage in the trabecular meshwork. Phacoemulsification and laser peripheral iridotomy (LPI) effectively control IOP elevation and widen the angle. This systematic review and meta-analysis compared Phacoemulsification and LPI Effectiveness for PACG. We searched Medline, Embase, and CENTRAL. We included randomized controlled trials (RCTs) that compared Phacoemulsification and LPI for individuals with PACG. We sought to evaluate the following outcomes: mean IOP, number of glaucoma medications, visual acuity (VA), visual field (VF) progression, peripheral anterior synechiae (PAS), Shaffer gonioscopy grading, central corneal thickness (CCT), central endothelial cell density (CECD), and poor response to surgery. The standardized mean difference (SMD) was used to represent continuous outcomes, while the risk ratio (RR) was used to represent dichotomous outcomes. 5 RCTs that enrolled 917 participants were deemed eligible. The phacoemulsification group showed statistically significance lower mean CCT and CECD and lower risk of poor response to surgery compared to LPI (SMD = -1.10; 95% -1.50, -0.70; P<0.001, SMD -366.12; 95% -652.59, -79.65; P=0.01, and RR 0.35; 95% 0.23, 0.54; P<0.001 respectively). There were no significant improvement in IOP and number of medications between both groups (SMD = -0.74; 95% CI = -2.26, 0.78; P=0.34, and SMD -17.58; 95% CI = -50.28, 15.12; P=0.29 respectively). Finally, there were also no significant differences in VA, VF progression, PAS, and mean Shaffer gonioscopy grading between both groups. Phacoemulsification showed statistically significant lower mean corneal thickness, central endothelial cell density, and lower risk of poor response to surgery compared to LPI. However, there were no significant differences in mean IOP, number of medications, VA, VF progression, PAS, and mean Shaffer gonioscopy grading between Phacoemulsification and LPI.

Medication therapy management (MTM) is provided by pharmacists and other healthcare providers, improves patient health status, and increases the collaboration of MTM providers with others. However, little is known about pharmacists’ intention to provide MTM services in Saudi Arabia. This study aimed to predict the pharmacists’ willingness in this nation to commit to providing MTM services there. This study used a cross-sectional questionnaire based on the theory of planned behaviour (TPB). The survey was distributed to 149 pharmacists working in hospital and community pharmacies. It included items measuring pharmacist attitudes, intentions, subjective norms, perceived behavioural control, knowledge about the provision of MTM services, and other sociodemographic and pharmacy practice-related items. The pharmacists had a positive attitude towards MTM services (mean = 6.15 ± 1.12) and strong intention (mean = 6.09 ± 1.15), highly perceived social pressure to provide those services (mean = 5.42 ± 1.03), strongly perceived control over providing those services (mean = 4.98 ± 1.05), and had good MTM knowledge (mean = 5.03 ± 1.00). Pharmacists who completed a pharmacy residency programme and had good knowledge of MTM services and a positive attitude towards them usually strongly intended to provide MTM services. Thus, encouraging pharmacists to complete pharmacy residency programmes and educating them about the importance and provision of MTM services will enhance their motivation to provide them.

Pharmacovigilance (PV) is an essential part of the healthcare system's framework. In Saudi Arabia, pharmacovigilance is still a relatively new concept though it is well established in many countries. In this study, we aim to evaluate knowledge, attitude, and practice regarding pharmacovigilance and barriers to reporting adverse drug reactions (ADRs) among the general public in Saudi Arabia. This is a cross-sectional study that used a self-administered online questionnaire to assess knowledge, attitude, and practice of PV and ADRs. The study included only the adult population in Saudi Arabia. A scoring system was generated with a scale from 0 to 100, where 80% was set as a cut-off point, as any higher score resembled adequate knowledge, a positive attitude, and good practice. We used the Statistical Package for Social Sciences (SPSS) version 26 for performing the statistical analysis, where para-normal tests were used to associate scores with the socio-demographic characteristics of participants. The study collected 1098 complete responses. The mean age (±SD) of participants was 37.9±11.2 years. Females comprised 68.9% of the participants. The average knowledge score among participants was 37.8±18.5, where only 4.3% of respondents had adequate knowledge. The average attitude score was 90.1±19.2, where 83.4% had a positive attitude. The average practice score was 70.4±18, and 34.5% of participants had good practice. The study found that the majority of participants had inadequate knowledge, a positive attitude, and poor practice. Individuals holding a master's degree or higher and those working in the healthcare sector had the highest knowledge scores, whereas the group aged 31 to 50 years old, participants from the Al Jawf region, participants who are married with children, holders of a master's degree or higher, and healthcare workers had the best attitude scores. Higher practice scores were seen among married individuals with children and those who work in the healthcare sector.

Background and Objectives: In 2020, one of the most important steps that were made was to give priority to the development of a COVID-19 vaccine to prevent the rising incidence of COVID-19 from continuing to rise. However, globally, there is a variable acceptance of the level of the COVID-19 vaccine. This study aims to explore Saudi parents’ willingness to vaccinate their children against COVID-19. Materials and Methods: This was a cross-sectional study; the online questionnaire was used to investigate the views of Saudi parents with children aged under 18 toward the immunization of their children against COVID-19. The data were gathered from 10 May 2022 to 31 October 2022. The data analysis uses SPSS version 20. A p-value of 0.05 or lower was regarded as statistically significant. Results: A total of 978 Saudi parents participated in this study. Most of the respondents were from the age group of 36–45 years with the educational qualification of high school and bachelor’s degree. Overall, it was observed that the majority, 98.2% of the respondents, disclosed that they needed more information (p = 0.004) about COVID-19 vaccine safety among children so that they could decide whether to vaccinate their child. About 91.4% of parents mention that vaccination against COVID-19 is not necessary for children (p = 0.001). About 68.3% of respondents agreed that getting vaccinated against COVID-19 could help Saudi Arabia control COVID-19 (p = 0.007, RI = 0.76). In terms of negative attitudes toward COVID-19 vaccination, 71.3% think that there will be severe side effects (p = 0.019, RI = 0.75); 67.7% think that the vaccine’s protection will only last for a short time (p = 0.055, RI = 0.72); 80.1% said they were afraid of getting vaccinated because of needle fear (p = 0.045, RI = 0.76), and 41.2% said lack of time was the main barrier to not vaccinating their child. Conclusions: Parents expressed concerns regarding the safety and efficacy of the COVID-19 vaccine, which might be some of the main factors influencing their decision to vaccinate their children. It is the need of the hour to take action to communicate, educate, and intervene with Saudi parents to enhance COVID-19 vaccination compliance rates across the board.

Providing palliative care to patients with life-threatening illnesses requires multidisciplinary efforts from different healthcare providers. Identifying the attitude, knowledge, and intentions of pharmacists to provide this service in Saudi Arabia is essential. Therefore, this study aimed to identify the palliative care knowledge, intentions, attitudes, subjective norms, and perceived behavioural control of pharmacists and what factors predict their intentions. Cross-sectional questionnaires based on the theory of planned behaviour were distributed to pharmacists in hospitals and community pharmacies. They included items that measured palliative care knowledge, attitudes, intentions, subjective norms, and the perceived behavioural control of pharmacists and identified other sociodemographic and pharmacy-practice-related items. In total, 131 pharmacists completed the questionnaires, showing an average score on palliative knowledge (8.82 ± 1.96; range: 1–14), strong intentions (5.84 ± 1.41; range: 1–7), positive attitudes (6.10 ± 1.47; range: 1–7), positive subjective norms (5.31 ± 1.32; range: 1–7), and positive perceived behavioural control (5.04 ± 1.21; range: 1–7). Having completed a pharmacy residency program, working longer hours per week, having a more positive attitude, and perceived stronger subjective norms were significantly associated with a strong intention to provide palliative care services. Therefore, enabling and motivating pharmacists to complete pharmacy residency programs and improve their attitudes could increase their intentions to provide these services.

Social media (e.g., Twitter) has been an extremely popular tool for public health surveillance. The novel coronavirus disease 2019 (COVID-19) is the first pandemic experienced by a world connected through the internet. We analyzed 105+ million tweets collected between March 1 and May 15, 2020, and Weibo messages compiled between January 20 and May 15, 2020, covering six languages (English, Spanish, Arabic, French, Italian, and Chinese) and represented an estimated 2.4 billion citizens worldwide. To examine fine-grained emotions during a pandemic, we built machine learning classification models based on deep learning language models to identify emotions in social media conversations about COVID-19, including positive expressions ( optimistic, thankful , and empathetic ), negative expressions ( pessimistic, anxious, sad, annoyed , and denial ), and a complicated expression, joking , which has not been explored before. Our analysis indicates a rapid increase and a slow decline in the volume of social media conversations regarding the pandemic in all six languages. The upsurge was triggered by a combination of economic collapse and confinement measures across the regions to which all the six languages belonged except for Chinese, where only the latter drove conversations. Tweets in all analyzed languages conveyed remarkably similar emotional states as the epidemic was elevated to pandemic status, including feelings dominated by a mixture of joking with anxious / pessimistic / annoyed as the volume of conversation surged and shifted to a general increase in positive states ( optimistic , thankful , and empathetic ), the strongest being expressed in Arabic tweets, as the pandemic came under control.

Background The coronavirus disease of 2019 (COVID-19) was spread all over the world, while diabetes mellitus (DM) remains the most prevalent chronic disease worldwide. Aims This study aims to investigate the effect of COVID-19 on glycemic control, insulin resistance (IR), and pH in elderly patients with type 2 diabetes. Methods  A retrospective study was conducted on patients with type 2 DM who were diagnosed with COVID-19 infection in the central hospitals of the Tabuk region. Patient data were collected from September 2021 to August 2022. Four non-insulin-based insulin resistance indexes were calculated for patients: the triglyceride-glucose (TyG) index, the triglyceride glucose-body mass index (TyG-BMI) index, the triglyceride to high-density lipoprotein cholesterol (TG/HDL) ratio, and the metabolic score for insulin resistance (METS-IR). Results Patients showed increased serum fasting glucose and blood HbA1c associated with a high TyG index, TyG-BMI index, TG/HDL ratio, and METS-IR as compared with results before COVID-19. Moreover, during COVID-19, patients revealed a reduction in pH, associated with a reduction in cBase and bicarbonate, and an elevation in PaCO as compared with their results before COVID-19. After complete remission, all patients' results turn back to their level before COVID-19. Conclusions Patients with type 2 DM who catch the COVID-19 infection suffer from dysregulation of glycemic control and elevated insulin resistance associated with a significant reduction in their pH.

Lichen planus (LP) is a common T-cell-mediated autoimmune skin disease, and its exact etiology is unknown. Typically, it affects the trunk, flexural surfaces, and the mucosa.We report a rare finding of LP involving both eyelids in a 67-year-old female. A 67-year-old Saudi female with a medical history of diabetes mellitus, hypothyroidism and rheumatoid arthritis presented with a three-month history of pruritic skin eruptions in both eyelids. She had no associated musculoskeletal symptoms or fatigue and no medical or family history of atopy. The patient had violaceous, thin, scaly plaques confined to both eyelids. Oral mucosa, genitalia, scalp, and nails were not affected. Histopathology from the right lower eyelid confirmed the diagnosis of LP. Hepatitis C virus serology was negative. Patient was examined by ophthalmology to rule out conjunctival involvement of LP. She had dry eyes only. She was initially managed by topical tacrolimus 0.1% ointment and didn't tolerate it due to severe reaction. She tolerated mometasone propionate 0.1% cream, which relieved the itch and partially improved the lesions. Although rare, LP of the eyelids must be considered among differential diagnoses of eyelid dermatitis. It can be confined, or it may concomitantly involve other parts of the body. LP of the eyelid may also extend to the conjunctiva, so it's important to screen patients by ophthalmology to rule out possible ocular involvement. This is the first case report of a Saudi patient with LP confined to the eyelid. The management of LP involving the eyelids is challenging. Treatment options include topical steroids, tacrolimus ointment, phototherapy and oral retinoids (etretinate).

Studies have explored how vitamin B12 status affects sleep among elders and children, but this remains to be investigated among young adults. We used the Pittsburgh Sleep Quality Index (PSQI) to assess the association between serum vitamin B12 and sleep among female college students in Saudi Arabia. In this cross-sectional study, we enrolled 355 participants (age (years), 20.7 ± 1.5; body mass index, 23.6 kg/m2 ± 5.2) at King Saud University, Riyadh, Saudi Arabia. Fasting blood samples were analyzed regarding the serum vitamin B12 and blood lipids. Anthropometric, socio-demographic, clinical history, stress, physical activity, and dietary data were collected. We assessed the sleep statuses of the participants using the PSQI. Around 72% of the participants were “poor” sleepers (PSQI > 5). Subgroup analysis within the tertiles showed that participants with higher vitamin B12 in the second and third tertiles reported better scores for sleep quality (B ± SE = −12.7 ± 5.6, p = 0.03; B ± SE = −32.7 ± 16.4, p = 0.05, respectively) and also reported a lower use of sleep medication (B ± SE = −21.2 ± 9.9, p = 0.03, in the second tertile only), after adjusting for the waist–hip ratio and stress. However, sleep was not found to be directly associated with either serum vitamin B12 or dietary vitamin B12. In conclusion, the serum vitamin B12 results show that the participants with higher vitamin B12 in the second and third tertiles reported better scores on the sleep quality scale and a lower use of sleep medication. However, no such associations were observed with the overall PSQI. More studies with larger sample sizes are needed to establish a direct relationship between sleep and vitamin B12.