Objective: To evaluate the impacts of a structured school-based educational intervention on obesity-related knowledge, binge eating behaviors, and anthropometric measures among intermediate school students in Makkah City. Methods: A one-group pretest-posttest quasi-experimental design was used. In total, 255 intermediate school students participated in a two-week obesity control program incorporating nutrition education, promotion of healthy lifestyle habits, awareness of binge eating disorder (BED), and physical activity guidance. Data were collected using a structured questionnaire to assess sociodemographic and anthropometric measures (body mass index (BMI) and waist circumference), obesity-related knowledge, and binge eating behavior using the Binge Eating Scale (BES). Statistical analyses were performed using SPSS to assess pre-post changes and associations. Results: The intervention led to a significant improvement in obesity-related knowledge, with median scores increasing from 11 (interquartile range (IQR): 8-14) pre-intervention to 15 (IQR: 12-18) post-intervention (p < 0.001). Knowledge scores were significantly higher for female students than males at both pre-and post-test (p < 0.001). In addition, students with lower knowledge were more likely to report moderate-to-severe binge eating behaviors both before and after the program (p = 0.017 and p = 0.004, respectively). BES scores had positive correlations with BMI, weight, and waist circumference, and negative correlations with knowledge scores. Logistic regression identified low pre-test knowledge as an independent predictor of moderate-to-severe binge eating symptoms (odds ratio = 0.871; 95 % confidence interval: 0.796-0.953, p = 0.003). Conclusion: The educational program effectively enhanced knowledge of obesity and eating behaviors among students. These findings highlight the link between psychological eating patterns and obesity risk, emphasizing the need to integrate emotional and behavioral components into school-based health education. Incorporating these multidimensional strategies may contribute to early prevention of disordered eating and long-term obesity.

INTRODUCTION AND OBJECTIVES:Despite low alcohol consumption across most MENA countries, the burden and management challenges of alcohol-associated liver disease (ALD) remain poorly characterized. This study assessed healthcare providers' perceptions, clinical experiences, and barriers to ALD care in the region. PATIENTS AND METHODS:A cross-sectional survey was distributed to clinicians involved in liver disease management in MENA. The survey explored perceived ALD prevalence, diagnosis patterns, clinical practices, access to services, and sociocultural barriers. Selected variables were compared across three subregions (Gulf, North Africa, and Levant & Turkey). RESULTS:A total of 286 providers from 16 MENA countries participated. ALD prevalence was perceived as low or moderate by most respondents, and 52.1% reported an increase in ALD case numbers over the past five years. ALD was commonly diagnosed during routine assessments or at advanced stages. Only 12.9% reported existing national ALD guidelines, and 28.3% had access to specialized clinics. Medical management and nutritional support were widely available, whereas liver transplantation was accessible to 54.5%. Stigma (76.6%) and limited treatment facilities (46.9%) were major barriers. CONCLUSION:This region-wide assessment highlights major gaps in ALD recognition, clinical pathways, and policy infrastructure. Reducing stigma, strengthening provider training, and developing region-specific guidelines are essential to improve ALD care in culturally sensitive settings.

Objectives: To evaluate the role of positive and negative social supports (PSS and NSS) in moderating the association of adverse childhood experiences (ACEs) with life satisfaction and mental health. Methods: A retrospective database analysis was done for the Biopsychosocial Religion and Health Cohort Study subjects (N = 10,194) residing in the United States and Canada (2006-2007). After controlling for confounders, a generalized linear model was used to evaluate the relationship between ACEs and life satisfaction and mental health, as well as the role of PSS subdomains (emotional, instrumental, informational, and companionship) and NSS subdomains (rejection or neglect, unsympathetic behavior, unwanted advice, and failure to provide help) had in these relationships. Result: The study sample was mainly composed of females (67.5 %) and Whites (63.6 %) with an average age of 61.65 +/- 13.59 years old. About 60.6 % of participants reported experiencing at least one ACE. ACEs have a negative association with life satisfaction and mental health. Better mental health and life satisfaction were favorably associated with PSS and negatively associated with NSS, respectively. With the exception of the rejection subdomain, NSS had no deteriorating influence on the relationship between ACEs and poor mental health and life satisfaction. In contrast, PSS significantly mitigated this relationship. Conclusions: When predicting both mental health and life satisfaction following ACEs, potential protective effects of PSS (mainly instrumental support) and debilitating effects of NSS (rejection) were noted. When interacting with individuals who have had ACEs, health providers need to be mindful of the possible effects of both PSS and NSS. More long-term studies are necessary, particularly in more diverse groups.

Objective:To assess the implementation of the Whole School, Whole Community, Whole Child (WSCC) model in public elementary schools in Makkah, Saudi Arabia, and examine its association with students' body mass index (BMI) and academic achievement. Methods:A cross-sectional study was conducted in 2022 across 20 elementary schools in Makkah using multistage cluster sampling. Participants included 385 students and 32 school staff from health-promoting schools (HPSs) and non-HPSs. Implementation of four WSCC domains; community involvement, family engagement, physical environment, and counseling services, was assessed using validated self-administered questionnaires. Academic scores, BMI, and sociodemographic data were collected. Data analysis utilized descriptive statistics, bivariate tests, Spearman correlations, and multivariable linear regression. Results:Students in HPSs reported higher WSCC implementation and academic achievement than those in non-HPSs (median score: 687 vs. 665, p = 0.009). In multivariable models, WSCC implementation remained an independent predictor of academic achievement after adjustment (B = 1.63, 95 % CI: 0.90, 2.35), whereas its association with BMI was not significant (B = 0.36, 95 % CI: -0.32, 1.04). A dual burden of underweight and overweight was observed. Conclusions:Strengthening WSCC implementation, especially mental health support, family and community engagement, and equitable policy adoption, may enhance students' learning and well-being.

Type 2 diabetes mellitus (T2DM) management relies significantly on medication adherence, yet non-adherence remains a prevalent issue affecting treatment outcomes. Understanding the factors contributing to non-adherence is crucial for developing effective interventions and improving patient care. This study aimed to assess medication non-adherence among T2DM patients following up with health coaches in primary healthcare centers (PHCCs) in Makkah City and identify associated factors influencing adherence levels. A cross-sectional study was conducted among 327 T2DM adult patients. Data on socio-demographic characteristics, clinical, medication-related, and psychological factors, barriers to adherence, and communication difficulties were collected by health coaches at all 24 PHCCs in Makkah City using a structured interview questionnaire. Medication adherence was assessed using the Morisky, Green, and Levine Medication Adherence Scale-4 (MMAS-4), and participants were categorized into low, intermediate, and high adherence groups. Statistical analyses, including chi-square tests and logistic regression analyses with crude and adjusted odds ratios (OR), were performed to identify significant associations and predictors for non-adherence. A total of 327 participants were included. Of these, 50.8

Background. Social support is an important determinant of the psychological health of women. Aim. To examine social support and its association with psychological distress among women in Saudi Arabia. Materials and Methods. Data were gathered between February and July 2023, using a cross-sectional, anonymous, online survey of women in Saudi Arabia above the age of 18 (n = 414). The multidimensional scale of perceived social support was utilized to gauge social support. The brief symptom rating scale, a 5-item measure, was used to measure psychological distress. Associations between social support and psychological distress were determined using linear regression considering potential covariates. Results. Results show high levels of psychological distress, with 38.1% of respondents scoring moderate to severe levels of psychological distress. The most commonly reported symptoms of distress were “feeling tense or high-strung” and “feeling easily annoyed or irritated,” with 39.4% and 34.5%, respectively, of respondents experiencing these symptoms moderately to extremely. Moderately high levels of social support were reported, with 77.1% of participants agreeing or strongly agreeing with the “my family really tries to help me” statement. Family/interpersonal relationships, however, were simultaneously the most commonly reported stressor over the past 3 years (59.4%). Unadjusted and adjusted analyses show social support was negatively correlated with psychological distress (β = −0.284, p <0.001; adjusted β = −0.145, p = 0.042), indicating higher levels of social support were correlated with reduced psychological distress. Conclusions. Findings indicate moderate-to-high levels of psychological distress as well as social support and an inverse association between them. This information can be used to inform intervention development. To better understand these domains as they relate to psychological distress, future research is warranted.

Rhinoplasty, which reconstructs the shape and size of the nose, is the most frequently performed cosmetic surgery procedure. Research indicates that social media is the leading influence motivating individuals to undergo rhinoplasty. Thus, we aimed to evaluate the effect of social media on the desire for rhinoplasty and to establish whether (and if so, how) social media enhances the recovery period after rhinoplasty. A retrospective study was conducted on 322 Saudi rhinoplasty patients through a questionnaire distributed online via specific rhinoplasty groups and accounts on different social media platforms containing rhinoplasty patients. The questionnaire included participants’ demographic details, the factors behind undergoing the rhinoplasty and their belief about the effect of social media on their desire to undergo a rhinoplasty, and how social media affected their recovery period after undergoing rhinoplasty. The collected data were then analyzed statistically with SPSS. The associations of different variables were found using the Chi-square test. The study included 322 rhinoplasty patients with nearly equal gender distribution. The results indicate that social media highly (mean = 4.07 ± 1.07 out of 5.00, 81.4

Both obesity and depression pose significant public health challenges. Understanding the age-gender differences in the BMI-depression associations is crucial, especially in the Saudi context, where cultural norms, lifestyle factors, and socio-economic conditions may significantly influence these associations. We aimed to explore and elucidate these associations in Saudi adults, considering age and gender as crucial factors. The research utilized a cross-sectional web-based survey to examine the impact of age and gender on the associations between BMI and depression. The study included 4,683 Saudi adults aged 18–60 years. The questionnaire assessed socio-demographics, lifestyle factors, chronic illnesses, and self-reported height and weight to calculate BMI. Depression Inventory-II (BDI-II), a self-reported scale, was used to evaluate depression, categorizing participants into depression and non-depression groups. A snowball convenience sampling was utilized, with clear inclusion and exclusion criteria established to mitigate potential biases. Data analysis was stratified by age and gender, and binary logistic regression was utilized to determine the associations between depression and BMI, incorporating odds ratios (ORs) in both crude and adjusted forms, along with 95

Background: Nasal bleeding, epistaxis, is a common emergency. Few Saudi studies exist on epistaxis awareness and first aid management. We aimed to assess knowledge and attitude of adults in Najran, Saudi Arabia towards epistaxis first aid management, as well as their association with sociodemographic factors.Methods: A cross-sectional web-based survey was carried out involving general adults of Najran, Saudi Arabia, using a snowball sampling method. A pretested questionnaire was utilized for data collection. Knowledge and attitude scores were categorized as good/positive or poor/negative. Both descriptive and inferential statistics were carried out with odds ratio (OR), 95% confidence intervals (CIs), and logistic regression analysis to investigate factors associated with knowledge and attitude towards epistaxis first aid management using SPSS Software.Results: The study included 518 participants with 58.9% experienced nosebleeds. Common causes were hypertension (24.5%) and nose injuries (23.7%). Factors as nasal dryness, blood thinner use, and tumors/nasal polyps were also identified. Around 60.2% believed first aid was necessary and 59.5% had good knowledge about epistaxis first aid management. Participants with university/higher education, employed in health sector, and with previous experience with nosebleed were more knowledgeable, more likely to have positive attitudes, and showed significantly higher ORs for knowledge and attitude scores compared to others.Conclusion: The study showed fair knowledge and attitude of Najran adults towards epistaxis first aid management with sociodemographic variables showing varying associations. Educational initiatives are needed especially for those with lower education, non-health sectors, and not experienced nosebleeds, to improve public first aid knowledge and attitudes.Keywords: Epistaxis; Knowledge; Attitude; First aid management; Saudi Arabia

Background: Harnessing digital technology for health service provision is inevitable, especially after the dramatic increase in demand during the COVID-19 pandemic and the observed global disruption of health services especially for People Living with Noncommunicable Diseases (PLWNCDs). Aims: To document and share experiences, challenges and lessons learned from the use of digital health interventions (DHIs) for noncommunicable disease (NCD) service delivery during the COVID-19 pandemic in the Eastern Mediterranean Region (EMR). Methods: We conducted a documentary research on the use of DHIs for continuity of NCD services during the COVID-19 pandemic in EMR. We collected our data using a questionnaire that was developed and administered by email to WHO NCD focal persons at the ministries of health of all EMR countries. Using the WHO classification of DHIs we then mapped the various interventions and the stakeholders involved. Results: Seven countries - Islamic Republic of Iran, Jordan, Oman, Qatar, Saudi Arabia, Sudan, and United Arab Emirates - shared their documentations. Documented DHIs used by countries to overcome the disruption of services during the pandemic were mostly on the use of client -to -provider telemedicine for NCD services. The level of implementation varied between countries. NCD and mental health helplines and COVID-19 prevention awareness campaigns for PLWNCDs were the most mentioned interventions. Conclusions: DHIs for NCD service provision were implemented during the COVID-19 pandemic in all settings: highmiddle- and low-income countries in the EMR. There is a high potential for incorporating DHIs within health systems to increase access to health services beyond the pandemic. Documentation, regulation and national capacity -building for mainstreaming DHIs in public health services in the EMR are strongly encouraged, based on each country's needs.

Background: Tuberculosis (TB) is a major cause of morbidity and mortality globally. Understanding its epidemiology and burden is critical for targeted interventions. Aim: To highlight the prevalence, incidence and treatment outcomes of TB in Egypt during the last 2 decades. Methods: For this systematic review and meta-analysis, we searched Medline/PubMed, ResearchGate, Google Scholar, and Scopus databases. We searched the local databases for unpublished studies, and the reports of international agencies, applying clear inclusion and exclusion criteria. The search covered prevalence; incidence; treatment outcomes; age, gender and residence of patients; and type of TB. Data were analyzed using STATA version 16.0. Pooled estimates with 95% confidence interval (CI) were calculated using a random effects model. Odds ratio (OR) with 95% CI was used as effect measures for related variables. Heterogeneity across studies was assessed using the I² statistic with sub-group analysis. Results: A total of 23 studies from 22 governorates, out of 27 governorates, involving a 139 597 study population met the eligibility requirements with no publication bias. The pooled prevalence was 8.70 (95% CI: 5.80–12.41, I² = 92.7%) and the pooled incidence was 9.10 (95% CI: 6.65–14.86, I² = 95.5%) per 100 000 population. About 82.6% of cases showed cured/completed treatment, 4.4% failure of treatment, and 3.9% died. In the subgroup analyses, the odds of TB prevalence were higher among males than females (2.05; 95% CI: 1.44–3.28), among those living in rural than in urban areas (1.29; 95% CI: 0.61–1.97), in Upper Egypt and Greater Cairo than in Lower Egypt and Delta Region (1.85; 95% CI: 0.97–4.15). The odds of pulmonary TB prevalence were higher than the extrapulmonary TB (2.43; 95% CI: 1.63–5.71). The odds of the treatment cases who were cured/completed (1.04; 95% CI: 0.96–1.51), failed (1.71; 95% CI: 1.35–2.73), and died (1.12; 95% CI: 0.87–1.60) were higher in Lower Egypt than in Upper Egypt. Conclusion: TB incidence decreased in Egypt over the last two decades, but treatment outcomes were unsatisfactory, with variations across the different regions. To achieve TB eradication in Egypt, efforts should be made to sustain the TB control strategy by improving treatment outcomes and intensifying case finding and surveillance reporting.

Background: Coronaviruses have been a significant hazard and one of the the most cause of human morbidity in recent years. Lack of knowledge and negative attitude toward COVID-19 and its vaccine among healthcare workers (HCWs) could lead to difficulties in controlling the infection with spread of infection among intra-hospitals Physicians and Nurses.Objective: To assess attitude, practice and perceived barriers to infection control toward COVID-19 among Physicians and Nurses) HCWs (in Kafr El Dawar Central, Dimisna Pediatric Speciality, and Itay El Barud General hospitals in El-Behera governorate during the period from December2022 and May2023. Methods:A cross-sectional web-based survey was designed using random sampling method and conducted on 1393 HCWs (doctors and nurses) at three hospitals in El-Behera governorate, Egypt.We used Google form sheet and printed questionnaires to collect answers of HCWs to each of the questionnaire items, then data were tabulated and statistically analyzed.

Background: COVID- 19 vaccines have been released, giving a major hope of getting rid of the dark pandemic crisis. The availability of vaccines does not necessarily mean that the mass vaccination program is a success. We aimed to investigate COVID-19 vaccination knowledge level, acceptance rate, and perception state among Egyptians. Methods: An analytical cross-sectional online survey was carried out utilizing a selfadministered adult questionnaire that assesses vaccination acceptance with related sociodemographic factors and perceptions based on health belief model perspectives. Predictors of vaccination acceptance were based on logistic regression analysis. Results: We analyzed data for 957 participants, aged 18–78 years, 55.7% were females, and 66.9% were healthcare workers (HCWs). About one-fourth had a history of confirmed COVID-19 infection and 56.5% would accept to have one of the COVID-19 vaccines, where “Pfizer” was the preferable one (37.8%), while “AstraZeneca” was the most rejected vaccine (26.8%). The 1st vaccine dose was received by 273 (28.5%) of which 260 were intended to receive the 2nd dose. Vaccine efficacy, side effects, protection time, and administration route were essentially among the factors that may influence their decision to accept COVID-19 vaccines. About 83.1% had good knowledge about vaccination which was significantly higher with increased age, among graduates/professionals, governmental workers, HCWs in addition to those able to save/invest money, had a history of confirmed COVID-19 infection and intending to have COVID-19 vaccine. Perceptions that vaccination decreases the chance of getting COVID-19 or its complications (OR = 9.28; CI: 5.03-17.12), vaccination makes less worry about catching COVID-19 (OR = 6.76; CI: 3.88-11.76), and being afraid of getting COVID-19 (OR = 2.04; CI: 1.26–3.31) were strong significant predictors for vaccine acceptance. Conclusions: Vaccine campaigns should emphasize vaccine benefits and highlight the severity of infection while addressing barriers to vaccination in order to improve vaccine coverage among populations.

Introduction. Depressive disorders are the leading causes of disability and disease burden worldwide. They were ranked fifth among the top causes of death and disability in Saudi Arabia, with subsequent impacts on productivity and economics when affecting adults. Objectives. The study aimed to systematically investigate the prevalence of depression and its associated factors among Saudi adults during 2000-2022. Methods. A systematic review and meta-analysis were conducted in accordance with the PRISMA guidelines using Medline/PubMed, ResearchGate, Google Scholar, and Ovid databases during 2000-2022 with predetermined inclusion and exclusion criteria. The quality of the included papers was determined, and heterogeneity between studies was assessed using the Q statistic to estimate the I 2 value. A random effects model was used to drive the pooled depression prevalence with 95% confidence intervals (CI). A forest plot was generated to show estimates for individual studies. Publication bias was assessed visually with the funnel plots symmetry and Egger’s test ( p < 0.05 ). A sensitivity analysis was conducted to explore the effect of individual studies on the overall prevalence estimate. A subgroup analysis by the study, population characteristics, and depression tools were also run. Results. Forty-six cross-sectional relevant studies were identified, including 25814 participants. The pooled depression prevalence was 37.35% (95% CI: 33.61–41.98%) with high heterogeneity ( I 2 = 94.8 %, p < 0.001 ). In the subgroup analysis, the prevalence estimates were higher among females (34.5%), the singles (49.5%), undergraduate university students in university settings (47.7%), northern region (62.3%), and studies that utilized the Center for Epidemiological Studies-Depression (CES-D) scale (58.8%). Among the risk factors significantly associated with depression were female gender, being single, low education level, financial problems, poor housing condition, having medical problems, sleep disorders, presence of psychiatric/psychological conditions, life events, lack of social support, exposure to stress, educational/personal problems, and smartphone addiction. Conclusion. Almost more than one-third of Saudi adults had depression. Appropriate surveillance, early interventions, and depression management strategies are needed to decrease the prevalence and its consequences among adults.

Background: In response to the growing burden of chronic diseases on the healthcare system and in pursuit of the health sector goals of Saudi Vision 2030, the Saudi Arabian Ministry of Health implemented an initiative known as health coaching, which helps patients with chronic diseases adopt a healthier lifestyle. This study aimed to assess awareness, knowledge, and attitudes towards the initiative for health coaches among public health students at Umm Al-Qura University in Makkah, Saudi Arabia.Methods: Data were collected using an online, cross-sectional survey between March 8, 2022 and April 4, 2022. Students from the Health Promotion and Health Education (HPHE) department were compared to students from other public health departments at Umm Al-Qura University. The questionnaire collected data on demographics and awareness, knowledge, and attitudes toward health coaching. Surveys that were at least 80% complete were retained for analysis.Results: A total of 311 students participated, of which 275 (88.4%) were unaware of health coaching and 156 (50.2%) had insufficient health coaching knowledge. However, 233 (74.9%) had a positive attitude about it. HPHE students scored significantly higher on most items than students from other public health departments.Conclusion: The students showed positive attitudes but had low scores on awareness and knowledge of health coaching. It is advisable to introduce health coaching into undergraduate medical school curricula. Future research should evaluate students from other health colleges and investigate the effectiveness of health coaching on cost and long-term outcomes of chronic diseases.

Celiac disease is showing a different epidemiological pattern in the last few years where the Middle East is involved now in its prevalence, not just Europe. Aim of the study: Evaluate the difference between Kuwaitis and non-Kuwaitis in the seroprevalence and histopathological pattern of celiac disease.

The correlation between nocturnal enuresis (NE) and sleep-disordered breathing (SDB) was reported. We aim to determine whether there is an association between NE and SDB in children and to assess the prevalence of SDB and NE in primary school children aged 6–12 years in Saudi Arabia. A cross-sectional observational study was conducted among the caregivers of children aged 6–12 years in all Saudi Arabia regions. The data were gathered through a self-administered online questionnaire. It included demographic information, weight and height, and associated comorbidities, in addition to the weekly frequencies of snoring symptoms and of enuresis, as well as of unrefreshing sleep using Likert-type response scales. Counts and percentages, the mean ± standard deviation, chi-square test, independent samples t-test, and regression analysis were used in the statistical analysis using R v 3.6.3. The questionnaire was completed by 686 respondents. Most respondents did not report any comorbidities in their children (77.1%). Asthma and adenotonsillar hypertrophy were reported in 16.2% and 15.6% of children, respectively. Unrefreshing sleep, mouth breathing at night, snoring, chronic nasal obstruction, and difficulty breathing while asleep were reported once or twice per week in 38%, 34%, 28%, 18%, and 18% of children, respectively. The prevalence of NE was 22.3%, with about 36.6% of children having NE two or more times per week. Significantly, NE was reported in 26.6% of children who slept before 10 PM compared to 19% of children who slept after 10 PM; in 28.6% of children who snored or loudly snored (57.1%) three times or more per week; and in 51.2% and 27.5% of children with difficulty breathing while asleep and who breathed through their mouth at night for one or two nights per week, respectively. A multivariable regression analysis showed that male gender (OR = 1.52, p = 0.010), obesity (OR = 1.24, p = 0.028), early sleeping time (OR = 1.40, p = 0.048), loud snoring for three or more nights per week (OR = 1.54, p = 0.001), difficulty breathing for one or two nights per week (OR = 1.85, p = 0.010), and mouth breathing at night for one or two nights per week (OR = 1.55, p = 0.049) were associated with higher odds of NE. Our study revealed that 22.3% of primary school children reported suffering from NE. SDB is a common problem among children with NE. The exact mechanism that links SDB to the increase in the risk of NE is unknown. Male gender, obesity, early sleeping time, loud snoring, difficulty breathing, and mouth breathing at night are potential independent risk factors of NE in school-age children.

Background The prevalence of obesity and depression shows an accelerating trend with increased risk of morbidity and disability. The exact underlying relationship between them is unclear. We aimed to evaluate the prevalence of body mass index (BMI) and depression and their associations in a large sample of Saudi adults. Methods We administered a nationwide cross-sectional web-based survey using a snowball sampling method among Saudi adults aged 18–60 years. We used a validated Arabic version of Beck’s Depression Inventory-II (BDI-II) for depression assessment. We classified BMI into underweight, normal weight, overweight, and obesity. We used logistic regression analysis to determine the factors associated with depression. Results Among 4,683 Saudi adults, different grades of depression were present in 43.3%, most (25.2%) with a mild condition. Overweight and obesity were present in 26.4% and 21%, respectively. We found a positive association between BMI and BDI-II score (ρ = 0.14, p = 0.006). BMI was significantly higher among those who were older, males, married, living in the Eastern region of Saudi Arabia, educated at a pre-university level, employed, at high family-income levels, smokers, and people with chronic diseases. Depression score was significantly higher among married, non-employees, non-smokers, people with chronic diseases, and those with BMI ≥ 25 kg/m 2 . Non-smoking, presence of chronic diseases, and being overweight or obese were significantly associated with depression. Conclusions Saudi adults were suffering from different grades of depression, overweight, and obesity. A positive association between BMI and BDI-II score was observed. Depression score did not differ by age, sex, geographical region, educational level, or family income. Non-smoking, presence of chronic diseases, and being overweight or obese were significantly associated with depression. Further longitudinal research is required to understand the factors underpinning causal relationships between BMI and depression, the subgroups’ variation, and mediating strategies.

Background: Mobile phones have become part of everyday life with a potential risk for microbial transmission. Makkah is a mass gathering city that may act as hotspots of disease transmission. The contact between public and both visitors and pilgrims to Makkah can't be overlooked, and any small outbreak within the public can be transmitted rapidly to them.Aim: We aimed to assess knowledge, attitudes, and practices (KAP) of general population towards infection transmission via mobile phones in Makkah and different characteristics relevant to KAP scores.Methods: A cross-sectional web-based survey was conducted on general population in Makkah city using a snowballing sampling method. Participants answered questions about their KAP towards infection transmission via mobile phone. The overall KAP scores were graded as good, fair, and poor and explored against different population characteristics using suitable statistical methods.Results: The study included 385 participants aged 15-64 years. About 88.8% owned personal mobile phone, 3.9% encountering a patient with infections transmitted via mobile phones, and 60.5% know nothing about potential role of mobile phones in infection transmission. Only 16.6% had good knowledge, 64.1% with positive attitudes, and 55.3% reported poor practices. The mean knowledge score was significantly higher among young adults (p = 0.002) and those with higher education (p = 0.005). Their mean attitude and practice scores were significantly higher among older adults (p < 0.001 and p = 0.015), female (p = 0.001 and p = 0.022), and those with higher education (p = 0.036 and p = 0.041) respectively.Conclusion: The overall public knowledge and practices towards the role of mobile phones in infection transmission in Makkah was below average though they have positive attitudes. Raising public awareness is important to decrease the possibility of cross-contamination via mobile phones and to develop adequate preventive strategies in a mass gathering setting like Makkah city.

Prevalence of lactose intolerance is not clear due to diversity and methodological limitations in the published literature [1]. Studies from the Middle East region, especially Kuwait, are limited. Lactase activity assay in small bowel biopsy is considered the gold standard for diagnosing lactose malabsorption. However, it is not commonly used as it is invasive with availability of non-invasive tests [2]. Aims & Methods : We aimed at comparing the prevalence of lactose intolerance among Kuwaitis and non-Kuwaiti expats resident in Kuwait. One hundred and seventeen consecutive patients were recruited from our outpatient clinics (52 Kuwaitis and 65 non-Kuwaitis). Patients were enrolled if they have symptoms of lactose intolerance (diarrhea, abdominal pain, bloating after milk products ingestion). Patients were subjected to upper gastrointestinal endoscopy and two post bulbar duodenal biopsies were tested using the Quick Lactase Test assays (Biohit Oyj, Helsinki, Finland) [5].