Search Results (154)

Background: Recently introduced nicotine pouches (NPs) are smokeless nicotine products. They are held between the lips and gums for 30 min to absorb nicotine into the bloodstream through the oral mucosa. Attractiveness may increase nicotine use, especially among young people and teens. The objective of this study is to investigate the health issues and psychological effects associated with nicotine pouch use among individuals in Saudi Arabia. Methods: A cross-sectional online survey using Google Forms. It was conducted between 13 February and 4 November 2025, in the Riyadh province of Saudi Arabia, restricted to users of nicotine pouches willing to answer a questionnaire on the occasion of buying them (at regional tobacco stores/supermarkets) or online via WhatsApp or the Telegram platform. Statistical analysis was conducted using SPSS Version 27, with a p < 0.05 indicating significance. Results: The current study included data of 489 participants, with a total of 395 participants using nicotine pouches. The most commonly reported symptoms were difficulty breathing and shortness of breath (both 40.5%), changes in taste or smell (36.7%), headache and stomach ulcers (33.4% each), and rapid or irregular heartbeat (28.4%). Most common psychological symptoms at any severity level (slightly to extremely) were appetite changes (78.7%), difficulty concentrating or focusing (75.4%), difficulty sleeping (74.9%), and increased anxiety or irritability (73.4%). Depression (72.2%), anger management (71.1%), and stress (70.4%) were also common. Regression analyses revealed that educational attainment was a significant predictor of both physical and psychological health outcomes. Conclusions: The findings show the most common physical symptoms were difficulty breathing and shortness of breath, followed by taste or smell changes, headaches, stomach ulcers, and rapid or irregular heartbeat. Appetite changes, concentration issues, sleep disturbances, and anxiety or irritability were common across all severity levels. Depression, anger issues, and stress were common. Full article

Background: Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder, with a prevalence of approximately 16% in Saudi Arabia. PCOS is associated with various health complications. Assessing the quality of life (QoL) of women with PCOS is crucial for effective management. Objectives: This study aims to translate and validate the Polycystic Ovary Syndrome Quality of Life scale (PCOSQOL) into Arabic for use among Arabic-speaking women. The study was designed to evaluate the psychometric properties of the Arabic PCOSQOL, including its reliability, validity, and responsiveness. Methods: A cross-sectional study was conducted among 207 Saudi women diagnosed with PCOS. Participants were recruited from family medicine and obstetrics and gynecology clinics at King Saud University Medical City, Riyadh, through an online survey. The PCOSQOL was translated into Arabic following the World Health Organization’s (WHO) forward–backward translation protocol. Psychometric evaluation included internal consistency, test–retest reliability (ICC), and construct validity. Results: The Arabic PCOSQOL demonstrated excellent psychometric performance, with high internal consistency (Cronbach’s α = 0.951) and good-to-excellent test–retest reliability (ICC = 0.760–0.885). Construct validity was supported by a four-factor structure explaining 62.5% of the total variance (KMO = 0.92; Bartlett’s p < 0.001). The subscales showed strong factor loadings (0.49–0.97). Older women (>25 years), married participants, and residents of the western and central regions reported significantly better quality of life (p < 0.05). Conclusions: The Arabic version of the PCOSQOL demonstrated excellent reliability, validity, and stability, confirming its suitability for assessing quality of life among Arabic-speaking women with PCOS. This validated tool can support both clinical practice and future research across Arabic populations. Full article

This study develops comprehensive Safety Performance Functions (SPFs) for various intercity road types in Saudi Arabia, including freeways, multilane highways, and two-lane two-way roads. Data spanning 2017–2019 were analyzed for five regions—Riyadh, Makkah, Eastern, Aseer, and Tabuk—using Negative Binomial (NB) regression models aligned with the Highway Safety Manual (HSM). A total of 26 SPFs were developed to predict total and fatal and injury (FI) crashes, incorporating contextual variables (e.g., tunnel density, U-turn frequency, high-speed vehicle proportion) and developing models separately for each region. It was found that as the median width increases on freeway roads in the Riyadh region, the predicted number of total and fatal and injury crashes decreases. Also, as the percentage of heavy vehicles and U-turn density increases, the number of total and fatal crashes increases on multilane roads in the Makkah region. Moreover, as the degree of curvature increases, the predicted number of total and fatal andinjury crashes increase on multilane and two-lane two-way roads in Tabuk. Lastly, in Aseer, median double marking and tunnel density along curves were significantly affecting crashes on two-lane two-way roads. This study is useful to enhance the methodology used to identify hotspots on the intercity roads in KSA. Full article

Background/Objectives: Human Respiratory Syncytial Virus (HRSV) is a major global cause of acute lower respiratory infections in children. With recent approval of pre-fusion F protein-based vaccines and monoclonal antibodies, ongoing molecular surveillance is critical. This study examined HRSV molecular epidemiology and evolution in Riyadh, focusing on mutations in the attachment (G) and fusion (F) glycoproteins and their potential impact on vaccine efficacy. Methods: Nasopharyngeal aspirates (NPAs) (200 samples) were collected from pediatric patients. HRSV-positive samples were typed, and the G gene hypervariable region and F gene were sequenced. Sequence and phylogenetic analyses were performed to identify circulating genotypes and amino acid substitutions. Results: HRSV was detected in 15% of samples, with HRSV-B slightly predominant over HRSV-A. Infants aged 2–5 months had the highest incidence rate of infection. The ON1 subgenotype remained dominant. The duplicated region of the G gene showed constrained evolution, with 18 variable and 6 conserved residues over 13 years. In the F protein, HRSV-A isolates exhibited high conservation, with only three amino acid substitutions in antigenic sites (Ø and II). Sites III, IV, and V remained fully conserved. In contrast, HRSV-B isolates displayed eight substitutions in antigenic sites, including six in site II (palivizumab-binding epitope). Conclusions: Given the highly effective HRSV prophylactics, including the approved vaccines and monoclonal antibodies, these mutations raise critical concerns regarding vaccine efficacy against HRSV-B. These findings underscore the necessity of sustained, seasonal molecular surveillance to monitor the emergence of variants and provide a molecular basis for further clinical studies. Full article

Urinary tract infections (UTIs) represent one of the most frequent bacterial infections worldwide, with Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) as the predominant uropathogens. The emergence of extended-spectrum β-lactamase (ESBL)-producing Enterobacterales has severely limited treatment options, making regional surveillance crucial. This study aimed to determine the prevalence of uropathogens, assess antimicrobial resistance patterns, and evaluate the burden of ESBL-producing organisms among patients presenting with suspected UTIs in a tertiary care hospital in Riyadh. We conducted a retrospective analysis of 19,556 urine cultures from a tertiary care hospital in Riyadh, Saudi Arabia, between January and December 2024. Of these, 2629 (13.4%) cultures showed significant bacterial growth, predominantly in females (83.2%) and in the 16–30 year age group. E. coli accounted for 65.9% of isolates, followed by K. pneumoniae (16.8%). ESBL production was detected in 28.5% of E. coli and Klebsiella isolates. ESBL producers exhibited complete resistance to third-generation cephalosporins and β-lactam/β-lactamase inhibitor combinations, whereas carbapenems, aminoglycosides, and fosfomycin maintained high efficacy. Resistance to ciprofloxacin and co-trimoxazole was widespread in both ESBL and non-ESBL isolates. Additionally, vancomycin-resistant enterococci (7%), methicillin-resistant Staphylococcus aureus (2%), and carbapenem-resistant Enterobacterales (0.9%) were found. These findings highlight the escalating burden of ESBL-associated UTIs and underscore the urgent need for strengthened antimicrobial stewardship, continuous surveillance, and optimized empirical therapy to mitigate the impact of multidrug-resistant uropathogens in clinical practice. Full article

Background/Objectives: Although several studies have shed light on the epidemiology of the influenza A/H3N2 subtype in Saudi Arabia, the knowledge regarding the molecular epidemiology and genetic diversity of the A/H3N2 subtype in the Riyadh region is still significantly restricted. Thus, the current research intends to investigate the molecular epidemiology and circulation patterns of the influenza A/H3N2 subtype in Riyadh, Saudi Arabia, over the past 9 years. Methods: A total of 380 nasopharyngeal aspirate samples (NPAs) (winter seasons 2020–2023) were screened for the presence of A/H3N2 subtype. Results: Sixty-five samples (17.11%) were found to be positive for the influenza A virus (IAV). A/H3N2 subtype 35 (9.21%) slightly predominated over A/H1N1 pdm09 30 (7.89%), the incidence rate was high in males (16.47%), and the most affected group was the 0–4 age group (14, 14.75%). The phylogenetic analysis revealed that the majority of Riyadh A/H3N2 samples were categorized into the sub-clades 3c.2a1b.1a and 3c.2a1b.1b, which did not exhibit any exclusive clustering with the vaccine strains. Out of the 20 amino acid substitutions detected in the HA1 domain of A/H3N2 strains, 9 were not found in any of the vaccine strains. The HA protein from the Riyadh samples has 8–11 N-glycosylation sites, some of which have been recorded in vaccine strains, yet are lacking in all strains analyzed in this study. Conclusions: As a result, the flu vaccines administered in Saudi Arabia might need to be reevaluated to incorporate additional vaccine strains that are more pertinent to those currently circulating in the recent epidemic seasons in Saudi Arabia. Full article

Background/Objectives: Motion sickness is a prevalent neuro-vestibular syndrome that affects individuals across various modes of transport and can significantly impact quality of life and travel safety. This study aimed to assess the prevalence, severity, and associated risk factors of severe dizziness related to motion sickness among adult residents in the Kingdom of Saudi Arabia (KSA), with particular focus on socio-demographic and behavioral determinants. Methods: A cross-sectional survey was conducted among 349 participants recruited primarily from the Riyadh region. A structured questionnaire captured demographic variables, personal health history, and experiences of dizziness and related symptoms during air or metro travel. Chi-square tests and multivariable logistic regression were applied to examine associations between dizziness and potential predictors, with p ≤ 0.05 considered significant. Results: Overall, (23.5%) of respondents reported experiencing severe dizziness during metro travel (82/349). Females were more affected than males (32.1% vs. 15.8%; χ²(1) = 12.06, p = 0.0005, Cramer’s V = 0.186), although this association lost significance in the adjusted model. Height showed a borderline association (p = 0.053). In multivariable analysis, previous similar episodes were the strongest independent predictor of dizziness (aOR 15.63, 95% CI 6.40–38.16, p < 0.001). ANOVA revealed no difference in severity by sex or height (p > 0.7). Conclusions: Motion sickness affects nearly one-quarter of Saudi metro travelers (23.5%) and is predominantly influenced by a history of previous similar episodes rather than demographic factors. These findings underscore the need for targeted preventive strategies, ergonomic vehicle design, and public health education to mitigate the burden of motion sickness in the KSA’s expanding transportation systems. Full article

Background/Objective: Transformational leadership (TL) by nurse managers is a modifiable organizational factor consistently linked to improved staff outcomes. However, evidence from the Arab Gulf region, particularly the Kingdom of Saudi Arabia (KSA), is limited. This study aimed to assess the relationship between nurse managers’ TL and staff nurses’ intent to stay and determine which TL dimensions predict intent to stay. Methods: A cross-sectional online survey was conducted among staff nurses at a three-hospital academic medical city in Riyadh, KSA. A total of 523 eligible respondents successfully completed the survey, utilizing probabilistic cluster sampling to guarantee representation from various nursing units within the medical city. Nurse managers’ TL was assessed across five dimensions by using the multifactor leadership questionnaire, and staff nurses’ intention to stay was measured using intent to stay scale. Descriptive statistics summarized the respondents’ demographic profile, nurse managers’ TL and staff nurses’ intent to stay. Normality was evaluated using Shapiro–Wilk and Kolmogorov–Smirnov tests. Relationships were examined using Spearman’s rank correlation, and multivariable ridge regression modeled the predictive contributions of the overall TL and its five dimensions to intent to stay. Results were considered significant if p < 0.05. Results: Nurse managers’ TL exhibited a positive association with staff nurses’ intention to stay in their current positions (r = 0.22, p < 0.001). Moreover, every dimension of TL demonstrated a strong positive relationship with the intent to stay (all p-values < 0.001). Multivariable ridge regression analysis revealed that the overall TL was a significant predictor of the intent to stay (β = 0.13, p < 0.001). Conclusions: The findings corroborate prior evidence linking TL to retention intentions. This underscores the practical salience of leadership competencies and attributes of nursing leaders, particularly TL, which recognizes the individual needs of staff nurses. This recognition subsequently fosters retention intentions, cultivates supportive nursing work environment, and enhances overall organizational success. Full article

Urban heat islands (UHIs) intensify thermal stress in cities, particularly in arid and semi-arid regions undergoing rapid urban expansion. The main objectives of this study are to quantify and compare UHI intensity in six major Saudi Arabian cities (Dammam, Makkah, Madinah, Jeddah, Riyadh, and Abha) representing diverse climatic zones and to examine how UHI patterns vary between urban, suburban, and rural zones over a 30-year period. Understanding the magnitude and spatial variability of UHIs across different climatic settings is crucial for developing effective urban planning and climate adaptation strategies in Saudi Arabia’s rapidly expanding cities. Except for Abha, these cities are the five most populous cities in the Kingdom. Each city was categorized into urban (>1500 people km⁻²), suburban (300–1500 people km⁻²), and rural (<300 people km⁻²) zones using high-resolution population density data. Two independent temperature datasets (ERA5-land and CHIRTS-ERA5) were analyzed for the years 1994, 2004, 2014, and 2024. Both datasets revealed consistent spatial patterns and a general warming trend across all zones and cities over the 30-year period. The UHI effect was most pronounced for minimum temperatures, with urban zones warmer than rural zones by 0.85 °C (ERA5-land) and 1.10 °C (CHIRTS-ERA5), likely due to greater heat retention and slower cooling rates in built-up areas. Mean temperature differences were smaller but still indicated positive UHI. Conversely, both datasets exhibited a reversed UHI pattern for maximum temperatures, with rural zones warmer than urban zones by 1.73 °C (ERA5-land) and 1.52 °C (CHIRTS-ERA5). This reversed pattern is attributed to the surrounding desert landscapes with minimal vegetation, indicated by low normalized difference vegetation index (NDVI), while urban areas have increasingly benefited from greening and landscaping initiatives. City-level analysis showed the strongest reversed UHI in maximum temperatures in Abha, while Jeddah exhibited the weakest. These findings highlight the need for localized urban planning strategies, particularly the expansion of vegetation cover and sustainable land use, to mitigate extreme thermal conditions in Saudi Arabia. Full article

Understanding long-term rainfall variability is essential for addressing Saudi Arabia’s growing challenges of water scarcity, climate resilience, and sustainable resource management in its arid to hyper-arid environment. This study analyzes the spatiotemporal variations and long-term rainfall trends across the 13 administrative regions of the Kingdom of Saudi Arabia (KSA) using four decades of observed data (1982–2021) from the National Center for Meteorology (NCM). The non-parametric Mann–Kendall (M–K) test and Sen’s slope estimator were applied to detect and quantify rainfall trends. Results reveal that 10 of the 13 regions show statistically significant negative trends, excluding the Eastern, Mecca, and Tabuk regions, with declines ranging from −4 to −16 mm/yr. The most pronounced decreases occurred in Hail, Al-Qassim, Riyadh, Medina, and Asir, while Mecca and Tabuk exhibited weak positive signals during the last decade, likely linked to Red Sea Trough dynamics. Seasonal analysis indicates the largest declines during winter and spring, crucial periods for groundwater recharge and agriculture, whereas summer rainfall remains localized in the southwestern highlands with a slight decreasing trend. Overall, rainfall variability in Saudi Arabia reflects both long-term drying and short-term oscillations. The findings provide a robust rainfall baseline to support water security, climate adaptation, and sustainable management strategies in one of the world’s driest regions. Full article

Background/Objectives: Patients with rheumatoid arthritis (RA) frequently experience depression and anxiety, adversely affecting their quality of life. Addressing mental health in this population is a key public health priority. This study is aimed at examining the influence of sociodemographic and lifestyle factors on these conditions, which is essential for comprehensive patient care. Methods: A cross-sectional study was conducted at a regional hospital in Riyadh between March and November 2022, involving 213 patients diagnosed with RA. Depression and anxiety levels were assessed using the Hospital Anxiety and Depression Scale, and sociodemographic and lifestyle information was collected via questionnaires and from patients’ medical records. To identify significant associations, bivariate and regression statistical analyses were performed. Results: The prevalence rates of depression and anxiety were 16.4% and 23%, respectively. Significant associations were found between sociodemographic factors (age, marital status, education level, healthcare facility type) and depression and anxiety levels. Lifestyle factors, specifically sugar-sweetened drink consumption, were significantly associated with anxiety. Conclusions: Sociodemographic and nutritional factors play a crucial role in shaping the psychological well-being of patients with RA. These findings highlight the importance of adopting holistic care strategies that address both the physical and mental health needs of these patients. Enhancing access to preventive medicine and public health services in Saudi Arabia is essential for achieving this goal. Future research should continue to explore these associations to guide the development of targeted interventions. Full article

This study examines how green finance drives sustainable economic development in Saudi Arabia, focusing on the Hail region, with comparisons across seven major cities (Riyadh, Jeddah, Mecca, Medina, Dammam, Tabuk, and Taif). Through an XGBoost machine learning approach enhanced by SHAP interpretation, we analyze how Green Finance Investment (IGF), Alternative and Nuclear Energy (ANE), Electricity Access (ATE), and Logarithmic Carbon Emissions (LCDE) influence New Business Registrations (NBR), Employment rates (EM), and Circular Economy outcomes measured via Combustible Renewables and Waste (CRW). Results reveal that ANE is the dominant predictor of employment across all cities, with SHAP values ranging from 76.9% in Hail to 96.6% in Jeddah. Entrepreneurial drivers vary regionally: ANE leads in Riyadh (63.1%) and Jeddah (73.3%), LCDE dominates in Hail (45.0%) and Taif (48.6%), and IGF is primarily evident in Tabuk (39.5%). Model accuracy varies, with RMSE being the highest in Hail (58.97) and lowest in Jeddah (433.86), highlighting structural differences across urban economies. Circular economy pathways diverge between LCDE-driven industrial modernization (e.g., Dammam, 62.9%) and IGF-driven greenfield development (e.g., Tabuk, 81.1%). These findings support a threefold city classification and provide actionable insights into Saudi Arabia’s Vision 2030 implementation. They inform targeted policy interventions, including green infrastructure investments in energy hubs, industrial modernization programs in manufacturing centers, and entrepreneurial financing mechanisms in emerging regions. Full article

Background: In healthcare institutions, radiologists play an essential role in patients’ care, enabling them to begin treatment and start their recoveries. However, data on the characteristics and distribution of the radiology workforce in Saudi Arabia are limited. Therefore, this study aimed to conduct a comprehensive analysis of the radiology workforce in SA based on national data and identify key distributional and specialty trends relevant to workforce planning and radiology service delivery. Methods: The following data were obtained from the Saudi Commission for Health Specialties (SCFHS) Registry: total number of registered radiologists, age, subspecialty, professional classification, place of qualification, and geographical location. Descriptive statistics were used for data analysis. Additionally, the findings were compared with those of published international benchmarks. Results: There were 5150 radiologists registered with SCFHS in SA, which corresponded to 147 radiologists per 1,000,000 inhabitants. The mean age was 40.8 years (standard deviation [SD] 9.8), with 60% of them being aged 30–44 years. Most of the radiologists specialised in general diagnostic radiology (83.7%), with few of them specialising in interventional radiology (1.8%), paediatric radiology (1.1%), and breast imaging (0.9%). The workforce mainly comprised consultants (35.0%), followed by registrars (29.7%) and senior registrars (22.7%). Two-thirds (65.0%) of the radiologists had obtained their qualifications abroad. More than half of the radiologists resided in three provinces: Riyadh (29%), Mecca (23%), and the Eastern Region (15%), while several provinces had fewer than 2% of the available workforce. Conclusions: The radiology workforce in SA is relatively young and has a higher density than the average in the European Union. Further, most of the radiologists are professionally classified as consultants or registrars. However, there is a clear imbalance in their geographic distribution, which is consistent with the population sizes of the respective cities. Targeted training expansion and reduced reliance on foreign-trained professionals are warranted to meet future service demands in line with the Vision 2030 objectives. Full article

Background: In the Kingdom of Saudi Arabia, various COVID-19 vaccines were administered during the pandemic. However, region-specific real-word comparative data on their immunogenicity remain limited. This study aimed to assess the serological responses to Pfizer-BioNTech (BNT162b2), Moderna (mRNA-1273), and AstraZeneca (ChAdOx1 nCoV-19) vaccines in a diverse population living in KSA. Methods: This observational study included 236 adults recruited from vaccination sites in Riyadh. Participants provided serum samples at predefined intervals: before the first dose, after the first dose, after the second dose, and post-vaccination infection (if applicable). IgG and neutralising antibodies were quantified using ELISA assays. Demographic and vaccination data, and their associations with antibody responses, were evaluated. Results: At baseline, 75.4% of participants were positive for SARS-CoV-2 IgG, suggesting high prior exposure. Marked incremental increases in IgG levels were observed after each vaccine dose. Both Moderna and Pfizer elicited stronger responses, with Pfizer inducing the strongest early response and Moderna achieving the highest overall titres. Among IgG-positive individuals, neutralising antibodies were detected in 98.1%. There were no statistically significant differences by age or gender, although males tended to show higher mean titres. Heterologous vaccine schedules induced comparable or enhanced immunogenicity relative to homologous schedules, supporting their use in flexible immunisation strategies. Conclusions: All COVID-19 vaccines administered in Saudi Arabia elicited robust antibody responses, particularly the mRNA-based vaccines. Our findings support their continued use and justify varied vaccination approaches, including mix-and-match booster strategies, to enhance community immunity. Full article

Human orthopneumovirus (HOPV) is a major cause of acute respiratory tract infection (ARI) in children around the world. The present study was conceptualized to detect and characterize human orthopneumovirus in 640 NPAs collected from symptomatic ARI pediatric patients younger than 2 years of age. The samples were collected from a hospital in Riyadh, Saudi Arabia, during winter 2022. Orthopneumovirus was detected in 98 (15.31%) of the 640 NPAs. No significant difference in the prevalence of HOPV-A (49%) and HOPV-B (51%) was observed during the study period as they circulated at similar frequencies. The HOPV-A strains (33) and HOPV-B strains (47) clustered into ON1 and BA genotype, respectively. The ON1 genotypes were further categorized into the subgenotype GA-2.3 and three different lineages, GA-2.3.5, GA-2.3.6a, and GA-2.3.6b, whereas the BA genotypes were categorized into the GB-5.0 subgenotype, entirely belonging to the GB-5.0.5a lineage. This is the first report to characterize orthopneumovirus strains from Saudi Arabia using a recently reported method. Several mutations, a few N-/O-glycosylation sites, and some purifying selections were observed in both the ON1 and BA genotypes. The present study demonstrates the equal prevalence of the ON1 and BA genotypes, in contrast to earlier reports on HOPV-A prevalence in the region. Understanding the change in the genotype distribution of HOPV requires the uninterrupted surveillance and genetic characterization of HOPV in circulating respiratory infections. These findings may contribute to a better understanding of HOPV evolution and the dynamics of its distribution at the local and global levels, resulting in improved understanding of epidemics. Full article