Saudi Journal of Health Research & Practice
Saudi Journal of Health Research and Practice (eISSN: 2961-4341) Welcome to SJHRP: Welcome to the Saudi Journal of Health Research and Practice (SJHRP), a peer-reviewed, open-access platform dedicated to advancing health research and fostering dialogue on critical health issues. We are committed to publishing high-quality, innovative research that enhances healthcare outcomes both in Saudi Arabia and globally. Our journal serves as a valuable resource for researchers, healthcare professionals, and policymakers to access cutting-edge studies and share impactful insights. As an open-access journal, all articles are freely available to read, download, and share, ensuring knowledge is accessible to a global audience. We invite you to explore our publications, contribute your research, and join the SJHRP community as we work together to drive meaningful progress in health research and practice. Aim of the journal: The Saudi Journal of Health Research and Practice (SJHRP) is a peer-reviewed, open-access (free for readers) journal dedicated to advancing knowledge and promoting dialogue on health issues pertinent to Saudi Arabia and the broader global context. The journal aligns with the Saudi Vision 2030 by focusing on the development of health research and its implications for improving the quality of life for individuals and communities. In addition, it seeks to contribute to Saudi Arabia's position as a world leader in scientific knowledge. SJHRP publishes original research articles, systematic reviews and meta-analyses, clinical case reports, commentaries, and editorials. Scope of the Journal: This journal covers all topics related to all aspects of health issues and healthcare research. Basic medical research with clear clinical implications will also be considered. Research fields of interest include but are not limited to: Public Health and Epidemiology Health Promotion and Disease Prevention Clinical Medicine Across All Specialties (including all clinical medical , dental and otherclinical specialties and subspecialities) Pharmaceutical Research and Development Biomedical Sciences and Technology Mental Health and Behavioural Science Environmental and Occupational Health Quality of Care and Patient Safety Health Informatics and Digital Transformation Health Education and Behavioral Science Health Economics and Policy Research Open access The Saudi Journal of Health Research and Practice (SJHRP) is a peer-reviewed and open access journal. Each article accepted by peer review fulfill prepublication requirements will be are promptly published in upcoming issues based on available slots. These articles will be made available online, immediately free to read, download and share.
Implementation of the History and Art of Medicine as an Elective Course for Medical Students: A Theoretical Review
The integration of the history and art of medicine into medical education offers a unique opportunity to improve the learning outcomes of future physicians. This review explores the theoretical foundations, benefits, and challenges of introducing such an elective course into medical curricula, as well as potential implementation strategies. By examining historical perspectives, artistic representations of medicine, and pedagogical approaches, this article argues that a deeper understanding of medicine’s cultural, creative, and historical context nurtures empathy, critical thinking, and professional identity among medical students. It also discusses potential barriers to implementation and suggests ways to overcome them, advocating for a multidisciplinary approach that bridges science and humanities in medical education.
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Assessment of Physical Activity and Perceived Barriers to Physical Activity Among Young Adult Women in the Jazan Region, Saudi Arabia
Low physical activity levels have been reported among women in Saudi Arabia. Studies investigating the barriers to physical activity among women in the Jazan region are limited. Therefore, this study aimed to assess the physical activity levels among young adult women in the Jazan region of Saudi Arabia and identify barriers to engagement in regular physical activity. A cross-sectional design based on a web-based survey was used. A total of 394 women with a mean age of 28.14 (SD 6.62) years participated in the study. Their physical activity levels were assessed using the International Physical Activity Questionnaire Short Form (Arabic version). The Self-Perceived Barriers for Physical Activity Questionnaire was utilized to evaluate barriers to physical activity. Approximately half of the female participants were physically inactive. The most frequently perceived barriers to regular physical activity included a lack of resources, a lack of energy, and a lack of willpower. Additionally, a lack of resources, fear of injury, and a lack of skill had statistically significant effects on the physical activity levels among the participants. Regarding demographic characteristics, the place of residence significantly influenced the levels of physical activity. Strategic interventions should be implemented to overcome these barriers.
Pathophysiological Mechanisms of Maternal Separation Stress in Cognitive Dysfunction
Maternal separation (MS) animal stress models are commonly used to evaluate the factors affecting cognitive development. These models simulate mother–offspring separation during the lactation period because it is the most critical neurodevelopmental period for exploring the impact of early-life adversities on the risk of various neurological and cognitive disorders that can occur during adulthood. Cognitive dysfunction may result from multiple contradictory mechanisms that have not yet been reviewed. Therefore, in this narrative review, we aim to offer a critical and objective review of studies published in databases, such as PubMed, Google Scholar, and Web of Science, over the last 5 years that have used this stress model to propose a pathophysiological mechanism of MS-induced cognitive dysfunction. Our review reveals that MS induces cognitive dysfunction via the hypothalamic–pituitary–adrenal axis, which may alter neurogenesis and/or apoptosis. Furthermore, MS leads to neuroinflammation, oxidative stress, mitochondrial dysfunction, and accumulation of neuronal aggregates. In conclusion, the MS stress model offers a cost-effective method to evaluate potential therapeutic agents for a variety of neurodegenerative and neuropsychological disorders. Integrating multidisciplinary research into assessments is a comprehensive strategy for the early prevention of these disorders, which is one of the main objectives of the Saudi Arabia 2030 vision for efficient child integration in society.
Demographic and Clinical Profiles of Patients with Breast Cancer in the Jazan Region: A Descriptive Analysis
Breast cancer is a leading cause of cancer-related mortality among women worldwide. Despite the availability of national data, research on the demographic and clinical characteristics of patients with breast cancer in the Jazan region of Saudi Arabia is limited. This study aimed to address this gap by analyzing local patient profiles and treatment patterns. A retrospective review of 98 patients with breast cancer who were treated in Jazan was conducted. Key demographic, clinical, and treatment data were collected, including information regarding disease stage at diagnosis, detection method, and treatment modality. Descriptive statistics were used to summarize the data. Factor analysis was used to explore treatment patterns, and logistic regression was used to examine the factors associated with mastectomy. Results: The mean age of the patients was 50.18 ± 13.03 years; most patients were Saudi (76.6%), married (59.2%), and housewives (85.7%). Comorbidities were present in 46.9% of the patients. The left breast was affected in 56.8% of the patients. Only 16.3% of the cancers were detected through screening; the remaining cases were identified symptomatically. Stages 2a (18.2%) and 4 were the most common. Mastectomy was performed in 51% of the patients, followed by chemotherapy (63.3%) and hormone therapy (43.9%). Two dominant treatment clusters emerged: one centered on mastectomy and chemotherapy and the other on breast-conserving surgery, radiation, and hormone therapy. No significant predictors of mastectomy were identified in this study. Most cases of breast cancer in Jazan were diagnosed in the late stages, with low screening uptake and a high reliance on mastectomy. The predominance of non-working women among these patients challenges assumptions linking occupational exposure to the risk of breast cancer. These findings underscore the need for targeted awareness campaigns, improved screening access, and further research on the risk factors and treatment outcomes in the region.
Familial Idiopathic Pulmonary Fibrosis (FIPF): A Comprehensive Review
Familial Idiopathic Pulmonary Fibrosis (FIPF) is a subset of idiopathic pulmonary fibrosis (IPF) characterized by familial clustering, affecting multiple relatives across generations. While most IPF cases are sporadic, FIPF accounts for approximately 5–20% of cases and is linked to genetic mutations that predispose individuals to the disease. This review provides a comprehensive overview of FIPF, focusing on its genetic basis, clinical manifestations, diagnostic approaches, and therapeutic strategies. It also highlights recent research findings and future directions in the field.
Familial Idiopathic Pulmonary Fibrosis (FIPF)
Epidemiological aspects of prematurity at Al Yamamah Hospital in Riyadh
Background: Prematurity continues to be the primary cause of infant mortality and morbidity globally. Proper, regular neonate screening is necessary to lower the burden of healthcare associated with prematurity and its complications. Aim: This study aimed to assess the epidemiological features of prematurity and survival rates in preterm neonates. Methods: Retrospective observational research was conducted at AlYamamah Hospital in Riyadh, Saudi Arabia, on preterm infants admitted to the neonatal intensive care unit with prematurity between January 2022 and July 2023. SPSS program version 22.0 was used for data analysis. Ethical approval was obtained from the ethics committee of King Fahd Medical Research Center. Results: A total of 402 participants were enrolled; 37.6% and 46.7% had very low birth weight and were very preterm, respectively. Significant inverse correlations were found between mortality, birth weight, and gestational age (P≤0.001). The major found complications were Patent ductus arteriosus (PDA) (14.2%) and pulmonary hemorrhage (11.2%). Conclusions: There was a male dominancy among preterm infants, and the largest proportions of the infants were very low birth weight and very preterm and experienced many complications, which were majorly PDA. There were inverse correlations between gestational age and birth weight with mortality rate and complications.
Primary Thyroid Tuberculosis: A Case Report from Jazan, Saudi Arabia
Thyroid tuberculosis is a rare disease. Diagnosis can be difficult because the clinical course is not very specific in most cases. Ziehl–Neelsen staining is frequently negative. Epithelioid granulomas and necrosis are the main biopsy findings. The diagnosis can be confirmed using polymerase chain reaction, detection of acid-fast bacilli, or bacteriological cultures. I report the case of a young patient who presented with anterior neck swelling. Primary thyroid tuberculosis was diagnosed based on the clinical picture and fine-needle aspiration cytology findings. Treatment with a combination of anti-tuberculous chemotherapy was initiated using the WHO category I regimen, and the patient showed an excellent response to treatment. To my knowledge, this is only the second clinical case of primary thyroid tuberculosis to be reported in Saudi Arabia. In conclusion, tuberculosis of the thyroid gland should always be considered in the differential diagnosis of goiters, albeit being rare. The presence of cold abscesses and discharging sinuses in the midline of the neck raises suspicion of this disease, especially in endemic areas. The clinical presentation, in addition to strong evidence from fine-needle aspiration cytology, is sufficient for the diagnosis of this condition.
Socio-demographic characteristics and their correlations with the vector-borne diseases in the Jazan region, Kingdom of Saudi Arabia
The vector-borne diseases (VBDs) can negatively affect not only public health in community but also, influence the community economy, life aspects, and quality. This study aims to examine the socio-demographics and evaluating people’s knowledge and experiences about vector-borne diseases (such as dengue fever, and malaria). So, an online survey with 44 questions was built, and 521 participants completed it to seek the required information in Jazan region. Also, data were collected and analyzed with the level of Statistical significance (P-value) of less than 0.05. Statistical findings indicate varied results, such as the socio demographic factors (gender, age, place of living, working status) have a weak negative association with the frequency of mosquito bitten (r=-0.098), while in the education level factor there is a very weak positive correlation (r=0.090 to r=0.155) with all VBD variables. However, the study reveals that there is a significant very weak positive association between socio demographic factors (educational level) with all VBD variables, while the other factors (such as gender, age, place of living, working status) showed other various findings. Although this study is considered a regional study, it can be generalized in many countries worldwide.
A Systematic Review of Image Quality and Dose Delivered by Cone Beam CT and Fan Beam CT: A Comparative Analysis
Introduction: Advances in medical imaging have led to the widespread use of Cone Beam Computed Tomography (CBCT) and Fan Beam Computed Tomography (FBCT) for three-dimensional anatomical imaging with reduced radiation exposure. Understanding the balance between image quality and radiation dose is critical for optimizing clinical outcomes and patient safety. Methods: This systematic review follows PRISMA guidelines to compare image quality and radiation dose between CBCT and FBCT. A systematic search identified 20 relevant studies, which were analyzed for study characteristics, imaging parameters, and key findings. Results: CBCT consistently offered superior imaging with lower radiation doses compared to FBCT. However, FBCT showed advantages in noise reduction, particularly in complex body regions. Most studies were of moderate to high quality, but protocol variability was noted. Conclusion: CBCT provides superior imaging with lower radiation doses than FBCT, while FBCT excels in noise reduction. Optimizing protocols and considering clinical requirements are crucial for selecting the appropriate modality. Future research should address protocol standardization and broader clinical aspects for enhanced utilization.
cone beam CT; fan beam CT; image quality; radiation dose
From Diagnosis to Treatment: Exploring Vascular Thrombosis in Antiphospholipid Syndrome Through a Case Report and Literature Review
Background: Antiphospholipid syndrome (APS) is a systemic autoimmune disorder characterized by recurrent arterial or venous thrombosis and pregnancy morbidity in the presence of antiphospholipid antibodies (aPLs). Maintaining therapeutic anticoagulation is critical to prevent recurrent thrombotic events, particularly in high-risk individuals. Case Presentation: We present a 33-year-old male with primary APS, a history of recurrent thrombotic events, and poor compliance with anticoagulation therapy, who presented with sudden-onset chest pain and dyspnea. Imaging confirmed pulmonary embolism (PE) with a solitary pulmonary nodule and ground-glass opacities. Echocardiography revealed moderate right ventricular dilatation, a small pericardial effusion, and an inferior vena cava fibrin clot. Laboratory findings confirmed primary APS with positive lupus anticoagulant and elevated beta-2 glycoprotein IgG. The patient was treated with low molecular weight heparin bridged to warfarin, achieving therapeutic INR, and discharged on lifelong anticoagulation. Discussion: This case underscores the high risk of recurrent thrombosis in APS patients who discontinue anticoagulation therapy. It highlights the importance of a multidisciplinary approach to management, patient education, and adherence to therapeutic anticoagulation. Current management strategies, challenges in risk stratification, and emerging therapies are discussed, emphasizing the potential for rapid recurrence upon treatment discontinuation. Conclusion: Lifelong anticoagulation remains the cornerstone of APS management to prevent recurrent thrombotic events. Close monitoring, patient education, and a multidisciplinary approach are essential to optimize outcomes and prevent complications in APS patients.
Prevalence of NER DNA repair gene XPG rs17655 C>G polymorphism among Saudi Populations: A Comparative Study with Global population
Environmental toxins damage DNA, increasing the risk of cancer if not repaired. Xeroderma pigmentosum group G (XPG) is essential for nucleotide excision repair (NER). The XPG exon 15 C>G polymorphism may influence this process, increasing the risk of cancer. We examined the frequency of the XPG exon 15 C>G polymorphism in the Saudi population and compared it with that in other populations. By conducting a PUBMED search, we identified epidemiological studies across different ethnic groups. Allele and genotype frequencies were determined, and statistical analysis was performed using the SPSS 21 software. In Saudi Arabia, the frequency of the mutant allele G was 57%, which was higher than that reported in the USA, Brazil, and China. However, higher frequencies of G alleles were found in Germany (79%), India (65%), Italy (75%), Romania (78%), Spain (75%), and Tunisia (61%). The frequency of the GG genotype in Saudi Arabia was 32%, which was higher than that in the USA (5%), Brazil (12%), and other countries but lower than that in Germany, India, Italy, Romania, Spain, and Tunisia. It was found that the XPG exon 15 C>G polymorphism has a unique frequency pattern in Saudi Arabia, probably due to ethnic differences. This study provided insights into the role of GG variants in the progression and therapeutic response of cancer, leading to improved treatments for the Saudi population.
Therapeutic efficacy of zinc sulfate in treating neonatal hyperbilirubinemia – A review of the recent evidence
When bilirubin levels exceed 5 mg/dL (86 μmol/L), it may indicate hyperbilirubinemia in newborns, sometimes requiring hospitalization for evaluation and treatment. Between the second and sixth days after birth, physiological jaundice usually peaks. Hemolysis, infections, premature delivery, breastfeeding exclusively, and hereditary predispositions are among the causes of elevated bilirubin levels. The Purpose of this review was to investigate the resent evidence on the causes and mechanisms of neonatal hyperbilirubinemia, identify risk factors and therapies, and evaluate the safety and efficacy of zinc sulphate as a phototherapy adjuvant. Research on zinc sulphate for treating hyperbilirubinemia in newborns was the primary focus of the literature review. Additionally, the mechanism by which phototherapy and zinc decrease enterohepatic circulation of bilirubin was examined. Zinc sulphate supplementation significantly reduces blood bilirubin levels, by increasing its removal through reducing the enterohepatic circulation. Zinc sulphate in conjunction with phototherapy was found to be more effective than phototherapy alone. Clinical trials demonstrated substantial decreases in serum bilirubin within 12 to 72 hours of zinc administration, reducing the duration of treatment. When combined with phototherapy, zinc sulphate shows promise in treating hyperbilirubinemia. This combination improves bilirubin reduction and may reduce the risk of bilirubin-induced neurotoxicity; however, zinc alone is insufficient. Further experimental studies are required to confirm these findings and establish a consistent treatment protocol.
Generalizability and Consistency of Derived Dietary Patterns across Gender and Residence Subgroups among University Students, Saudi Arabia
Background: Numerous studies have been reported dietary patterns among university students, however specific research on generalizability and consistency of dietary patterns across student subgroups is limited. Aim: Study aimed to explore empirically dietary patterns and to assess the generalizability and consistency of the explored dietary patterns across subgroups of gender and residence among university students. Methods: Cross-sectional study between 2023 and 2024 conducted among undergraduate students at College of Nursing and Health Sciences. In total 650 (Boys:350, Girls:300) students dietary intake collected using food frequency questionnaire. Both exploratory and confirmatory factor analysis used to explore the dietary patterns. Congruence coefficient was used to assess the generalizability and consistency of the factors between subgroups of gender and residence. Results: Identified four optimal dietary patterns. Western foods pattern-salty snacks/chips, fried foods, cake/biscuits/sweets, soda drinks, pastries/pizza and drinks/juices. Traditional foods pattern-breakfast/seeds, meats/chicken, rice/pasta/potatoes, traditional foods, milk/milk products and egg. Protein foods pattern-processed meat and fish/seafoods. Lastly prudent foods pattern-fruits, nuts, vegetables and legumes. Conclusions: Empirically explored dietary patterns were generalizable and consistent across subgroups of gender and residence. Further, research with longitudinal setting is required to assess the relationships between dietary habits and chronic diseases.
Evaluation of Program Learning Outcomes in the Clinical Nutrition Curriculum
Background: Assessing Program Learning Outcomes (PLOs) ensures academic curricula align with competencies needed for professional success, particularly in health fields. This study aims to evaluate the PLOs of the Clinical Nutrition (CLN) program at Jazan University. A mixed-method approach was adopted to assess PLOs validity, reliability, and achievement. Further, content and construct validity were assessed with Content Validity Ratio (CVR) and Exploratory Factor Analysis (EFA) respectively. Reliability was assessed using Cronbach's alpha, and aggregates were calculated for 2024 academic cohort examination scores to evaluate PLOs achievement. CVR of the 11 PLOs ranged from 0.5 to 0.9, indicating a strong alignment with educational objectives. EFA yielded a Kaiser-Meyer-Olkin value 0.92, affirming the construct validity. The Cronbach’s alpha 0.799, confirmed internal consistency among the PLOs. Aggregates of examination scores showed high achievement (more than 85%) in all PLOs except S4 and S5 from skills domain. In conclusion, this study underscores the significance of robust assessment practices in higher education programs, demonstrating that CLN program PLOs effectively guide student learning and align with accreditation standards. Continuous evaluation and refinement of these outcomes are essential to maintain educational quality and ensure graduates are well-equipped for professional challenges in the health sector.
National Center for Academic Accreditation and Evaluation
Evaluation of training for undergraduate medical students in gynecological ultrasonography skills
The integration of ultrasound training into various clinical courses for undergraduate medical education is slowly expanding. We evaluated an ultrasound training program to enhance the integration of ultrasound education into the curricula of various medical colleges. A total of 202 fifth-year medical students participated in ultrasound training sessions. Performance assessments comprised subjective pre- and post-training evaluation surveys completed by the students, along with an objective assessment by the trainers at the end of the training sessions. The Wilcoxon matched-pairs signed-rank test was used to evaluate the differences between pre- and post-training survey questions, with p<0.05 considered significant. All tests were found to be p<0.0001, indicating significantly better post-training evaluation scores. In the objective assessment (maximum score: 110), the median total score given to students was 106, reflecting the trainers’ satisfaction with the students’ performance. In conclusion, the training program in the study was successfully conducted by four instructors, completed in eight training sessions over a 2-week period. Some medical colleges express concern regarding insufficient time and limited resources to incorporate ultrasound training into their educational programs. The present study provides a straightforward and effective training approach within the available faculty resources and curricular time.
Parents' Knowledge and Awareness of Sickle Cell Disease in the Jazan Region, Kingdom of Saudi Arabia: A cross-sectional study
Sickle cell disease (SCD) is a significant genetic health concern worldwide. The Jazan region in Saudi Arabia has the second-highest rate of SCD, emphasizing the need for comprehensive data on disease knowledge and awareness in this region. This study evaluated parents' understanding of SCD in the Jazan region and determined the knowledge gap. After expert consultation and a literature review, we conducted an online survey to enroll 384 Saudi citizens over 18 years of age living in Jazan, aiming for a 95% confidence level. The data was analyzed using SPSS v23.0. Most participants (n=358; 93.2%) were aware of SCD, with 303 (78.9%) knowing it is a blood disorder. About 331 (82.6%) agreed that premarital investigation is necessary to reduce SCD incidence, and 276 (71.9%) knew that genetic counseling could help manage it, but only 95 (24.7%) had checked their genotype. Over one-third of participants (n=144; 37.5%) believed genetic testing should be conducted in primary school, while 52 (13.5%) understood the likelihood of a child inheriting SCD if both parents had sickle cell traits. The study revealed a good awareness of SCD but significant gaps in the understanding of its genetic transmission, highlighting the need for expansive education and awareness campaigns in the Jazan region to improve genetic counseling and health management decisions.
Genetic Evaluation of a 30-Year-Old Female with Unilateral Renal Agenesis: A Case Study
Unilateral renal agenesis (URA) is a congenital anomaly where one kidney fails to develop, often diagnosed in childhood or prenatally. While many cases are asymptomatic, URA is associated with long-term renal risks and potential genetic implications. This study presents the case of a 30-year-old female with incidentally detected URA, evaluating her renal function, genetic background, and clinical implications. Ultrasound confirmed a solitary kidney with no surgical history. Renal function tests were normal. Genetic analysis revealed no pathogenic variants, suggesting a sporadic occurrence. This case highlights the importance of URA diagnosis in asymptomatic adults, emphasizing long-term monitoring and genetic evaluation to guide clinical management and patient counseling.
Barbeya Oleoides Leaves Extract Mitigates Acetaminophen- Induced Nephrotoxicity by Reducing Oxidative Stress and Inflammation in a Rat Model
Acetaminophen is widely used as an analgesic and antipyretic, but its potential for nephrotoxicity, particularly in overdose situations, remains a significant concern. Identifying agents that can mitigate this nephrotoxicity is crucial for kidney protection. Barbeya oleoides Schweinfurth (BOL), known for its antioxidant and anti-inflammatory properties, may offer protective effects against acetaminophen-induced kidney injury. This study investigates the nephroprotective potential of an ethanolic extract from BOL leaves against acetaminophen-induced nephrotoxicity. Five groups of rats (n = 6 per group) were treated orally for seven days: Group 1 received a placebo solution (vehicle), Group 2 received a single acetaminophen dose (2 g/kg) on day 5, Groups 3 and 4 received BOL at doses of 100 or 200 mg/kg, respectively, along with acetaminophen on day 5, and Group 5 received only BOL (200 mg/kg). Acetaminophen significantly increased the level of the kidney function biomarkers blood urea nitrogen (BUN), triglycerides (TG), uric acid (UA), and creatinine, indicating renal dysfunction. It also elevated pro-inflammatory cytokines, specifically tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β), highlighting an inflammatory response. Furthermore, a notable reduction in antioxidant enzyme levels, namely glutathione (GSH), catalase (CAT), and superoxide dismutase (SOD), was observed, signifying oxidative stress and impaired antioxidant defense. Histopathological examination showed disruption of the glomerular basement membrane, confirming renal tissue damage. BOL co-treatment restored kidney function biomarkers and antioxidant levels, reduced cytokine levels, and preserved renal tissue structure suggesting improved oxidative balance. In conclusion, BOL leaves extract demonstrated significant nephroprotective effects against acetaminophen-induced nephrotoxicity by reducing oxidative stress and inflammation, highlighting its potential as an adjunct therapy to prevent acetaminophen-induced kidney injury.