bluuebunny/crossref_metadata_2025_split huggingface dataset:
Building Individual and Community Resilience for LGBTQIA+ Individuals in India: A Pilot Study using the SAAHAS intervention model
Authors: Nigudkar Advaita S. , Wandrekar Jagruti R. 
Published: September 2024

Abstract

Background:
Exploring factors that determine resilience in the Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, and Asexual+ (LGBTQIA+) community as described in the minority stress model and developing interventions to promote individual and community resilience are emerging goals to facilitate LGBTQIA+ mental health. In this pilot study, researchers’ objectives were two-fold to build a participant-derived theory on resilience in the LGBTQIA+ community and to develop and evaluate the feasibility and usefulness of an intervention module to build resilience.

Methods:
Online group therapy sessions were conducted under the Sexuality, Awareness, Acceptance, Health, and Support (SAAHAS) framework, with queer mental health professionals as facilitators using a peer-cum-expert stance. Following a detailed intake and assessment using the Connor Davidson Resilience Scale, a group discussion on Understanding Resilience in the first session was used to identify resilience components. In the remaining 6 sessions, facilitators primarily used Queer Affirmative Cognitive Behavior Therapy techniques pertinent to these components to address challenges in the domains of self, family of origin, and intimate partner relationships. A feedback form was used after the final session to evaluate usefulness.

Results:
The 6 components identified as crucial to LGBTQIA+ resilience were building self-worth, stigma competence, cognitive coping, emotional coping, general social and interpersonal skills, and accessing information and resources. 27 participants from the LGBTQIA+ community attended at least one session. Participant feedback suggested that the participants believed that the group was a safe space, perceived an increase in their resilience after the intervention, reported improvement on all 6 resilience components, and believed that they had better skills to navigate challenges in the 3 settings of self, family, and intimate partner relationships.

Conclusion:
The SAAHAS intervention module can be a useful cost-effective framework to promote individual resilience, and the group therapy setting itself is a useful tangible community resilience resource.
Electronic and Regular Cigarette Use among King Saud University Students and their Association with Psychological Distress
Authors: Dabbagh Rufaidah , Barnawi Ruba , Alrsheed Atheer , Alsalem Ruba , Alanzan Shahd , Alhuthail Aroob , Alhogail Norah 
Published: September 2024

Background:
The growing trend of electronic cigarette (e-cigarette) use among the youth is concerning. This behavior has not been well studied among Saudi young adults, let alone among females.

Aims and Objectives:
We measured the prevalence of e-cigarette and regular cigarette use among female university students, their association with psychological distress and student characteristics, and the reasons for smoking.

Materials and Methods:
We conducted a cross-sectional study among 616 female students at King Saud University, from January to March 2019. Self-administered questionnaires were used asking about regular and e-cigarette use behavior, and psychological distress measured by 6-item Kessler Psychological Distress Scale (K6).

Results:
The response rate was 91.5%, and 7.8% of students smoked regular cigarette, while only 2.6% smoked e-cigarettes. About 86.9% of students had K6 scores suggestive of high levels of stress. Students whose friends smoked had around 16 times the odds for e-cigarette use (odds ratio [OR]: 15.75; 95% confidence interval [CI] = 7.45, 33.31), and 11 times the odds for regular cigarette use (OR: 11.40; 95% CI = 5.31, 24.47) compared to those without friends who smoked. The reasons for smoking e-cigarettes were peer pressure (35.6%), believing they are safer than regular cigarettes (32.2%), for quitting regular cigarettes (25.4%), and out of curiosity (6.8%).

Conclusion:
Although e-cigarette use prevalence does not seem quite high in this study, the prevalence of regular cigarette smoking was surprisingly higher. Peer pressure and having friends who smoke are important predictors of cigarette use that should be targeted in tobacco prevention planning.
Migraine and Psychiatric Comorbidity among Arabs Living in Different Societal Environments
Authors: Ras Yasmin Abo , Alnafisah Mohammed Saleh , Farfouti Mohammed Taher , Alsukhni Rana Alnasser , Alanazy Mohammed H. , Muayqil Taim A. 
Published: September 2024

Background:
The prevalence of migraine and psychiatric comorbidities has been found to differ on a global scale according to country development. We aimed to determine this prevalence in three samples of Arabs living in different countries at different levels of development and political stability.

Methods:
The study included Saudi and Syrian participants ≥16 years of age. The cohort was subdivided into three groups: Saudi Arabian residents (SARs), Syrian residents (SRs), and Syrian expatriates (SEs). Information regarding age, sex, education, and marital status was also collected. Migraine was determined by the International Classification of Headache Disorders-3 criteria; depression and bipolar disorder were determined by the Patient Health Questionnaire-9 and the Mini-International Neuropsychiatric Interview, respectively. Odds ratios were estimated for associations.

Results:
Of 620 participants, 102 (16.5%) met migraine criteria, and 81 (79.4%) were female. Migraine was found in 66 (20.6%) SARs, 25 (19%) SEs, and 11 (6.5%) SRs. Being married was significantly associated with migraine (P = 0.01). Depression had a significant association with migraine within the entire cohort (odds ratio [OR] =2, confidence interval [CI] =1.2–3.1, P = 0.004) and the subgroups of SEs (OR =3, CI =1.14–7.8, P = 0.02) and SARs (OR =2.1, CI =1.14–7.8, P = 0.02); depression was significantly associated in the SE and SAR migraine groups (both P = 0.02).

Conclusion:
Migraine and comorbid depression occur at a rate similar to international reports in Middle Eastern Arabs and more prominently in SEs and SARs. The migraine frequency was lower in SRs in comparison to SEs and SARs residing in more developed countries. Future research that explores these conditions under different environmental and sociopolitical circumstances will improve the understanding of causal relationships.
Impact of the Coronavirus Disease 2019 Pandemic on an Ongoing Pragmatic Pediatric Clinical Trial
Authors: Hudairi Abrar F. , Bashiri Fahad A. , AL-Sulimani Lujain K. , AlSaqabi Dimah , Mohamed Mohamed A. A. , Hamad Muddathir H. , Al Khalifah Reem 
Published: September 2024

Background:
The coronavirus disease 2019 (COVID-19) pandemic has a significant negative impact on clinical trials. Therefore, maintaining an optimal trial conduct should be considered to minimize risks to trial integrity while ensuring the safety of trial staff and participants. In this study, we aimed to describe the impact of the COVID-19 pandemic on conducting an ongoing clinical trial, along with challenges and solutions encountered and required to continue the trial.

Methods:
This Phase IV pragmatic randomized superiority controlled open-label trial included children with epilepsy receiving Vitamin D supplementation at King Saud University Medical City, Riyadh, Saudi Arabia (clinicaltrials.gov registration number: NCT03536845). Children with epilepsy receiving chronic antiepileptic medications and with normal baseline 25-hydroxyvitamin D level were randomized to receive cholecalciferol 400 IU/day versus 1000 IU/day for 6 months. The primary outcome was the percentage of children with Vitamin D insufficiency at 6 months. The secondary outcomes included seizure control, bone mineral density, and safety.

Results:
Under COVID-19 public health emergency measures, exceptional methods were used, such as telemedicine, home visit for blood extractions, shipping of the study medication to the patient's home, using reminder text messages to follow patients' compliance, and using privacy-compliant platforms to connect the research team members.

Conclusion:
During the widespread pandemic, ethical dilemmas are of major concern, especially when conducting trials on vulnerable age groups. Therefore, actions should be proportionate and based on benefit-risk considerations, affecting the risk of bias from protocol deviation and overall results.
The Psychometric Properties of the Arabic Version of the Fear of COVID-19 Scale
Authors: Khalifah Reem Al , Younis Afnan , Al Suwaidan Hessah I , AlAnazi Noor , Baghdadi Leena R 
Published: September 2024

Aim:We aimed to translate and perform transcultural adaptation of the English version of the Fear of COVID-19 Scale (FCV-19S) to Arabic, and assess predictors of COVID-19 fear.Methods:We translated the original seven-item English FCV-19S to Arabic, then back-translated the scale to English. The scale was evaluated by a group of medical experts and participants from the general population to test for content and face validity. The final version of the scale was assessed in a cross-sectional study that included adults residing in Saudi Arabia, who participated in a study to assess the impact of COVID-19 fear on children's vaccination during the COVID-19 pandemic curfew March 24–July 6, 2020.Results:Overall, 577 participants responded to the survey. The mean age was 32.6 ± 5.7 years, and the majority had bachelor's or postgraduate university degrees. COVID-19 was diagnosed in 1.4% of the participants. The mean total score for the COVID-19 fear scale was 20 ± 5.4. The COVID-19 fear scale had excellent internal consistency and Cronbach's alpha 0.85 (95% confidence interval 0.93–0.96).Conclusions:The modified Arabic version of the FCV-19S is a valid and reliable tool to measure fear levels during the pandemic of COVID-19. Using an appropriate psychometric tool to measure the level of fear can help in monitoring changes in population fear levels, and implementing population-level measures to limit unwarranted fear.
Low Back Pain Prevalence and Associated Risk Factors among Medical Students at Four Major Medical Colleges in Saudi Arabia
Authors: Alrabai Hamza M. , Aladhayani Mohammed H. , Alshahrani Salem M. , Alwethenani Zaid K. , Alsahil Mohammed J. , Algarni Abdulrahman D. 
Published: September 2024

Aim:
The aim of this study was to determine the prevalence of low back pain (LBP) and to identify risk factors associated with LBP among medical students.

Materials and Methods:
A cross-sectional study was conducted among 2021 medical students from four medical colleges in Saudi Arabia during the academic year 2019–2020. A self-administered questionnaire was conducted and included three sections: demographic data, risk factors of LBP, and prevalence of LBP (during lifetime, past 12 months, and past 7 days). Data were analyzed using SPSS.

Results:
A total of 2021 medical students responded to our survey. The participants were 57.1% female and 42.9% male. Most of the students' ages (76.3%) ranged from 20 to 24 years. Medical students younger than 20 and older than 24 were 21.8% and 1.9%, respectively. The prevalence of LBP was 80.7% at any time, 67.6% in the past 12 months, and 38.2% in the past 7 days. Females were found to have higher prevalence of LBP than males (P < 0.0001), 95% confidence interval (CI) (1.37, 2.04). History of physical trauma to the back was significantly associated with LBP (P < 0.0001), 95% CI (1.32, 2.40). A lack of daily exercise was also found to be associated with LBP (P = 0.015), 95% CI (1.05, 1.55). LBP affected the daily functions, such as walking and sleeping, of 30.1% of medical students. Around 11% of medical students sought medical care because of LBP.

Conclusions:
We conclude that the prevalence of LBP is high among Saudi medical students. LBP seemed to be higher in females and associated with history of back trauma. Back care awareness should be emphasized among medical students.
Effect of Radiological Grade of Cochlear Ossification on Cochlear Implant Outcome in Postmeningitis Deafness
Authors: Alzhrani Farid , Alassiry Hassan , Alorainy Ibrahim A. , Albadr Fahad B. , Abdulsamad Yassin , Aldhaferi Ahmad 
Published: September 2024

Objectives:
Cochlear implantation provides significant benefits to patients with postmeningitis deafness; however, the prediction of the outcome is difficult. Therefore, the goal was to investigate whether there is a correlation between cochlear implantation outcome in postmeningitis deafness and the radiological grade of cochlear ossification.

Methods:
In this retrospective cohort study conducted at King Abdulaziz University Hospital, Riyadh, Saudi Arabia, between January 2013 and December 2017, nine patients with 14 diseased ears were included. All patients with postmeningitis deafness who had cochlear ossification and underwent cochlear implantation were included. Patients' demographic data and postoperative audiological outcome were recorded. Preoperative computed tomography (CT) and magnetic resonance imaging (MRI) findings were independently reviewed by two neuroradiologists and graded for cochlear ossification. The correlation between the preoperative radiological grade of cochlear ossification and postcochlear implant audiological outcome was examined.

Results:
The mean duration of deafness before implantation was 6.5 months, and the average PTA4k for all included ears was 28.9 dB. The average speech reception threshold was 22.5 dB. There was no significant difference in the audiological outcome between the different radiological degrees of cochlear ossification using either MRI or CT.

Conclusion:
The present study showed that the radiological degree of cochlear ossification postmeningitis is not a useful predictor of the audiological outcome postcochlear implant. However, the small sample size remains a major limitation of the current study.
Selenium Protects against Tenofovir/Lamivudine/Efavirenz-Induced Nephrotoxicity in Rats
Authors: Adikwu Elias , Ezerioha Chidi Emmanuel , Biradee Innocent 
Published: September 2024

Context:
Tenofovir/lamivudine/efavirenz (TLE) used for the treatment of human immunodeficiency virus may cause acute or chronic nephrotoxicity.

Aim:
This study assessed the ability of selenium (Se) to prevent TLE-induced nephrotoxicity in albino rats.

Materials and Methods:
Forty healthy male albino rats (200–250) randomized into four groups (n = 10) were used. Group 1 (Control) was orally treated with normal saline (0.2 mL) daily for 90 days. Group 2 was orally treated with Se (0.1 mg/kg) daily for 90 days. Group 3 was orally treated with TLE (8.6/8.6/17.1 mg/kg) daily for 90 days. Group 4 was orally co-treated with Se (0.1 mg/kg) and TLE (8.6/8.6/17.1 mg/kg) daily for 90 days. After treatment, the rats were anesthetized and blood samples were collected and evaluated for serum renal function markers. Kidneys were examined for histology and oxidative stress indices.

Results:
Kidney oxidative damage in TLE-treated rats were marked by significant (P < 0.001) decreases in glutathione (GSH), GSH peroxidase, superoxide dismutase, and catalase levels with significant (P < 0.001) increases in kidney malondialdehyde levels when compared to control. Altered serum renal biochemical markers in TLE-treated rats were characterized by significant (P < 0.001) increases in creatinine, uric acid, and urea levels with significant (P < 0.001) decreases in total protein, albumin, bicarbonate, sodium, chloride, and potassium levels when compared to control. Tubular necrosis, lipid accumulation, and mesangial proliferation were observed in the kidneys of TLE-treated rats. TLE-induced nephrotoxicity was significantly (P < 0.01) reversed in Se supplemented rats when compared to TLE.

Conclusion:
Se may be clinically used for TLE-associated nephrotoxicity.
Patient’s Psychological Perception of Topical Anesthetic in Reducing Dental Needle Pain: A Descriptive Study
Authors: Fatani Bader Abdulmohsen , Alhilal Abdulrahman Ibrahim , Alkhamali Ibrahim Sanad , Alhizam Abdulmohsen Abdulrahman , Alrumayyan Saleh Firas , Kalanta Rania 
Published: September 2024

Background:
Needle fear is one of the most common fears in dental treatment, thus, patients’ demand for topical anesthetics has been increasing significantly. Topical anesthetic has always been generally supported as a technique for decreasing anxiety and discomfort related to needle insertion and its important part in the atraumatic injection of local anesthesia.

Objective:
This study aims to investigate patients’ psychological and physiological aspects of topical anesthetics in reducing dental needle pain.

Materials and Methods:
The data were collected from patients attending the Dental University Hospital at King Saud University in Riyadh, Saudi Arabia. The targeted subjects were patients with no previous or current history of psychological impairment or prior history of pain disorder.

Results:
The most commonly perceived benefits of topical anesthesia were local numbness (50.1%) and relaxation (33.0%). Most of the participants had ever requested a topical anesthetic before injection. The most common reasons were anxiety and tension due to needle pain (53.2%) and previous experiences with injection-related pain (42.9%).

Conclusion:
This study showed that the topical anesthetic has a significant psychological impact on patient’s attitudes toward dental treatment with most patients demanding topical anesthetic before dental injections to reduce their level of anxiety and fear before dental injections.
Effect of COVID-19 on Awareness and Consumption of Dietary Supplements in Saudi Arabia
Authors: Alshammari Sulaiman Abdullah , Alwakeel Leena Sami , Alghtani Jumana Abdullah , Alsabbagh Laila Mahmoud 
Published: September 2024

Objectives:
We aimed to determine the role of the COVID 19 pandemic on dietary supplements' awareness, beliefs and consumption.

Methods:
A cross-sectional online-based survey distributed through social media was done on 575 participants aged 18 and above and living in Saudi Arabia. The Questionnaire contains sociodemographic, prevalence, type, pattern, and habit of D. S. usage and the effect of COVID-19 on consumption. Data were analyzed using SPSS version 24.

Results:
The users of D. S. 145 (25.5%), aged between 18 and 25 years old, with higher education levels and higher income. 58% used D. S. before the march, and 66% of D. S. users declared that COVID-19 did not affect their consumption decision. Most D. S. used was vitamins/multivitamins among males and females and were not influenced by anyone to enhance overall health and wellness. D. S. users have used the designated dosage based on the information on the product (43%) and took it randomly without specific time (38%). Our participants agreed on D. S. being harmless, useful, and have an impact on sports performance. They also disagreed on the necessity of D. S. for all ages. Respondents believe Vitamin D is essential for immunity and Vitamin C has a role in cold/flu prevention.

Conclusion:
Most of our respondents get their information from nonmedical sources even though they displayed the right level of awareness and were mindful of D. S.'s limited role in health during the pandemic.
Epidemiological Aspects and Diagnostic Accuracy of Morphological Diagnosis of Hydatidiform Mole Using p57kip2 Immunostain in Nnewi, South-East Nigeria – A Multicenter Study
Authors: Ndukwe Chinedu Onwuka , Ukah Cornelius Ozobia 
Published: September 2024

Introduction:
There have been numerous studies on hydatidiform mole (HM) in Nigeria, but some lacked histological diagnosis, and others did not differentiate complete hydatidiform mole (CHM) from partial hydatidiform mole (PHM). In addition, none of these studies involved immunohistochemical (IHC) diagnosis or assessed the accuracy of morphologic diagnosis of CHM. The objective of this study is to determine the epidemiology and accuracy of morphologic diagnosis of CHM using p57KIP2 IHC stain.

Materials and Methods:
The paraffin blocks of histologically diagnosed cases of CHM and PHM seen at two histopathology laboratories in Nnewi, South-East Nigeria, were retrieved from the archives. IHC staining for p57KIP2 was done.

Results:
In this study, we reviewed and reclassified 54 cases of routinely stained HMs as 15 (27.8%) CHMs and 39 (72.2%) PHMs. However, following IHC staining, we further reclassified them as 21 (38.9%) CHMs and 33 (61.1%) PHMs. Discordant histopathological diagnosis between routine staining with hematoxylin and eosin (H and E) and IHC staining with p57KIP2 was identified in eight cases (which constitutes 14.8% of the studied cases): one case was a false-positive diagnosis, while the remaining seven cases were false-negative diagnosis. Thus, the sensitivity and specificity of histopathological diagnosed cases of CHM by H and E were 66.7% and 97%, respectively, with a positive predictive value of 93.3%, negative predictive value of 82.1%, and total accuracy of 85.2%.

Conclusions:
Morphology alone is suboptimal for accurate diagnosis of CHM. We therefore strongly recommend the routine use of p57KIP2 immunostain in all suspected cases of HM.
Approach for an Undergraduate Surgery Course Teaching and Assessment during the COVID-19 Pandemic in Saudi Arabia
Authors: Alsheikh Sultan , Alhassan Noura , Alfraih Yasser , Alqahtani Hamad , Soliman Mona M. 
Published: September 2024

Background:
The COVID-19 pandemic has caused a sudden shift to online education worldwide. Online education is a challenging experience in medical education. This study describes the approach toward teaching and assessment upon the sudden shift to online education in the undergraduate surgery course due to lockdown and the perception of students. It also describes the preparation for the succeeding new academic year.

Methods:
In May 2020, after the complete lockdown, online small group interactive tutorial sessions were conducted for the 3rd-year surgery course that included case-based discussion and demonstration of certain clinical skills. The final assessment of the course was delayed to August 2020. Forty-five faculties participated in the exam. Each had 7–6 students to examine a total of 315 students. Seven different sets for the examination were used. Seven closed-ended questionnaires were distributed to the students' online using Google surveys after the final exam students. The questionnaire assessed the students' satisfaction of the urgent arrangement in the course and exams due to the COVID-19 pandemic situations. Likert scale was used to receive students' feedback on 5-point scale.

Results:
All sessions recorded a participation of 71–92 students. A total of 12 lectures covering four topics and three online surgical clinical topics were conducted using zoom. A total of 288 students of 315 attended the final written exam and 287 attended the objective structured clinical examination (OSCE). A total of 144 students of 293 (49%) responded to the 7 questionnaires that were distributed. Regarding the students' agreement on their benefit from the online tutorials. Fifty-nine percent of the respondents agreed that the tutorials improved their clinical sense and developed interest in surgical skills, while 41% of the students disagreed. The majority of the students agreed on the relevance of the topics discussed in the online tutorials. The majority of students agreed that the online tutorials helped to improve their understanding and knowledge of the topic. In response to whether the online tutorials helped to improve understanding and knowledge of the surgical topics, the majority of the students agreed.

Conclusion:
Online medical education for undergraduate surgery courses for 3rd-year medical students is a novel and effective method for managing the urgent situation. Students were overall satisfied with the approach and reported that it helped them to achieve the designed learning objectives.