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26 pages, 572 KB  
Article
Smoking Abstinence Self-Efficacy, Decisional Balance, and Quitting Desire Among Adult Smokers in Saudi Arabia: Gender-Based Cross-Sectional Study
by Samiha Hamdi Sayed, Olfat Abdulgafoor Gushgari, Fadiyah Abdullah Alshwail, Hanan Abd Elwahab Elsayed, Hanem Awad Mekhamier and Ebtesam Abbas Elsayed
Healthcare 2025, 13(17), 2158; https://doi.org/10.3390/healthcare13172158 - 29 Aug 2025
Abstract
Background: Smoking is a major public health concern in Saudi Arabia, with significant gender differences influencing smoking behavior and cessation. Aim: This study aimed to investigate smoking abstinence self-efficacy (ASE), decisional balance (DB), quitting desire, and their predictors among adult male and female [...] Read more.
Background: Smoking is a major public health concern in Saudi Arabia, with significant gender differences influencing smoking behavior and cessation. Aim: This study aimed to investigate smoking abstinence self-efficacy (ASE), decisional balance (DB), quitting desire, and their predictors among adult male and female smokers in Saudi Arabia. Methods: A cross-sectional study was conducted using a convenience sample of 375 male and 220 female adult smokers recruited via social media. Data were collected through an online survey assessing personal health, smoking behavior, desire to quit, ASE, and DB. Logistic regression was used to identify predictors of earnest quitting desire, high ASE, and negative DB. Results: Males were more likely to smoke for 10 or more years (70.7% vs. 29.1%), maintain regular smoking patterns (86.9% vs. 54.1%), and exhibit high nicotine dependence (29.3% vs. 6.4%) compared to females. A higher proportion of females (76.8%) than males (66.9%) expressed a strong desire to quit. ASE was generally higher in males, with 49.6% showing average levels, while 46.4% of females had low ASE, particularly in social and positive mood contexts. Females displayed a higher prevalence of negative DB (73.6% vs. 58.1%), indicating greater awareness of smoking’s drawbacks. Both genders acknowledged the cons of smoking, though males perceived fewer pros. Conclusions: A complex interplay of factors influences smoking behavior and cessation among adult smokers. Gender differences also play a crucial role in smoking cessation factors among Saudi adults. Tailored cessation strategies addressing self-efficacy and motivation are recommended to enhance quitting success. Full article
13 pages, 244 KB  
Article
The Weight of Emotions: Childhood Obesity and Psychosocial Well-Being in Saudi Arabia
by Rabab Majzoub, Khalid Al Noaim, Abdulrahman Alnaim, Muneera Alabdulqader, Zainab Al Alawi, Sayed Ali, Abdulrazag Ibnshamsah, Abdulaziz Alanazi, Aljawhara Al Omair, Ahad Alaklabi, Kholud Alqhtani and Maha Alaklabi
Healthcare 2025, 13(17), 2152; https://doi.org/10.3390/healthcare13172152 - 29 Aug 2025
Viewed by 127
Abstract
Background/Objectives: Childhood obesity is a growing public health concern globally, with significant physical and psychological implications. While numerous studies have linked obesity to poor mental health outcomes, cultural differences may influence this relationship. This study examines the association between childhood obesity and psychological [...] Read more.
Background/Objectives: Childhood obesity is a growing public health concern globally, with significant physical and psychological implications. While numerous studies have linked obesity to poor mental health outcomes, cultural differences may influence this relationship. This study examines the association between childhood obesity and psychological well-being among Saudi children aged 8–12 years. Methods: A cross-sectional case-control study was conducted in Al-Hofuf, Saudi Arabia. A total of 128 children were recruited, divided into a high-body-weight group (n = 64) and a healthy-weight group (n = 64). Psychological well-being was assessed using the Psychological Well-being Scale for Children (PWSC) and the Stirling Children’s Well-being Scale (SCWS). Anthropometric measurements were recorded, and parental body mass index (kg/m2) data were included. Data analysis was performed using SPSS 2023, employing chi-square tests and t-tests. Results: No statistically significant differences were found between the children’s body mass index (kg/m2) groups across most psychological well-being dimensions. However, a significant association was observed between maternal body mass index (kg/m2) and children’s PWSC scores (χ2 = 6.217, p = 0.045), suggesting a potential influence of parental weight on child well-being. Additionally, a significant sex difference in SCWS scores was noted, with males displaying higher well-being levels than females (χ2 = 7.798, p = 0.041). Family income and school grade showed no significant associations with psychological well-being. Conclusions: Contrary to findings from Western studies, childhood obesity did not significantly impact psychological well-being in this Saudi sample. Cultural factors, parental influence, and age-related differences may contribute to these results. Further longitudinal and qualitative research is needed to explore these associations in greater depth. Full article
(This article belongs to the Special Issue Interventions for Preventing Obesity in Children and Adolescents)
13 pages, 261 KB  
Article
Musculoskeletal Pain Among University Students and Its Correlations with Risk Factors: A Cross-Sectional Study
by Sultan Ayyadah Alanazi and Faizan Zaffar Kashoo
J. Clin. Med. 2025, 14(17), 6076; https://doi.org/10.3390/jcm14176076 - 28 Aug 2025
Viewed by 144
Abstract
Background: Several studies have examined the prevalence of musculoskeletal pain (MSP) among university students internationally. We aimed to assess the prevalence, pattern, and potential risk factors for MSP among Majmaah University students in Saudi Arabia. Methods: A cross-sectional questionnaire was administered to students [...] Read more.
Background: Several studies have examined the prevalence of musculoskeletal pain (MSP) among university students internationally. We aimed to assess the prevalence, pattern, and potential risk factors for MSP among Majmaah University students in Saudi Arabia. Methods: A cross-sectional questionnaire was administered to students from different faculties at Majmaah University. We collected data via the validated Arabic versions of the Standardized Nordic Musculoskeletal Questionnaire, the International Physical Activity Questionnaire, and the Perceived Stress Scale. Bivariate and multivariate logistic regression analyses were performed to explore associations between MSP and demographic, ergonomic, lifestyle, and psychosocial variables. Results: A total of 257 students (n = 195, 75.9% female; n = 62, 24.1% male) were included in this study. The 12-month prevalence of MSP was 225 (87.5%), with the lower back (n = 119, 46.3%) and neck (n = 113, 44.0%) regions being the most affected. Compared with male students, female students reported a higher MSP prevalence (90.3% vs. 79.0%, p = 0.035). The multivariable model was significant (likelihood-ratio χ2 = 26.042, df = 7, p < 0.001), accounted for Nagelkerke R2 = 0.182 of variance, and showed good calibration (Hosmer–Lemeshow χ2 = 8.505, df = 8, p = 0.386). Perceived stress was the only independent predictor of 12-month MSP (β = 0.084, adjusted OR = 1.087, 95% CI 1.034–1.143, Wald χ2 = 10.732, p = 0.001), while sex, smoking, academic workload, and sleep duration were non-significant (all p > 0.127). Conclusions: MSP appears to be prevalent among Majmaah University students, with psychological stress emerging as a key independent risk factor. Preventive strategies should include stress management prioritization and ergonomic and physical activity education to support university student well-being. Full article
12 pages, 317 KB  
Article
Pharmacists’ Interventions in Virtual Diabetes Clinics: Cost-Effectiveness Feasibility Study
by Sinaa Al-Aqeel, Alaa Mutlaq, Njood Alkhalifa, Deem Alnassar, Rashed Alghanim, Wafa Algarni and Sultanah Alshammari
Healthcare 2025, 13(17), 2130; https://doi.org/10.3390/healthcare13172130 - 27 Aug 2025
Viewed by 223
Abstract
Background: Telepharmacy, the provision of patient care services by pharmacists through the use of telecommunications technology, is associated with improved diabetes-related outcomes and access to healthcare. The primary aim of this study was to characterize pharmacists’ interventions at a virtual pharmacist-led diabetes clinic [...] Read more.
Background: Telepharmacy, the provision of patient care services by pharmacists through the use of telecommunications technology, is associated with improved diabetes-related outcomes and access to healthcare. The primary aim of this study was to characterize pharmacists’ interventions at a virtual pharmacist-led diabetes clinic (PLDC). The secondary aim was to assess the feasibility of conducting a future cost-effectiveness study of the PLDCs. Methods: This prospective observational feasibility study was conducted within a pharmacist-led clinic at Seha Virtual Hospital, Riyadh, Saudi Arabia. Two intern pharmacists collected data between 31 July 2024 and 31 January 2025. Results: Seventy-five patients (mean [SD] age 50.47 years [14.95]) attended the clinic. The majority were female (58.7%), had type 2 diabetes (86.6%), and were from outside Riyadh (97.3%). The communication with patients was carried out mainly via telephone (73, 97.3%). The mean consultation duration was 7.64 min (SD = 5.68). A total of 179 interventions were conducted, with a mean number of interventions per patient of 2.5 (median 3, min 0, max 5). The most common intervention was patient education and counseling about their disease and medications. While it was feasible to capture the details of pharmacist interventions and resource use data, incomplete data on patient outcomes presented a challenge. Conclusions: Our detailed documentation of pharmacist–patient encounters revealed the ability of pharmacists to identify and manage the problems of diabetes patients at virtual PLDCs. Our feasibility study identified a few challenges that need to be addressed when designing future cost-effectiveness studies. Full article
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15 pages, 361 KB  
Article
Caffeine Consumption and Risk Assessment Among Adults in Saudi Arabia: A Cross-Sectional Study
by Lulu A. Almutairi, Abdullah A. Alsayari and Amani S. Alqahtani
Beverages 2025, 11(4), 123; https://doi.org/10.3390/beverages11040123 - 21 Aug 2025
Viewed by 342
Abstract
Background/Objectives: This study aimed to assess the consumption of caffeinated beverages and the associated caffeine intake among Saudi adults, alongside a quantitative risk assessment using the hazard quotient (HQ) approach. Methods: A cross-sectional study was conducted, utilizing a validated Arabic Beverage Frequency Questionnaire [...] Read more.
Background/Objectives: This study aimed to assess the consumption of caffeinated beverages and the associated caffeine intake among Saudi adults, alongside a quantitative risk assessment using the hazard quotient (HQ) approach. Methods: A cross-sectional study was conducted, utilizing a validated Arabic Beverage Frequency Questionnaire to collect data on beverage consumption patterns. The participants reported the type, frequency, and quantity of caffeinated beverages consumed. We also calculated caffeine intake and assessed the associated health risks. Data were collected from 4367 participants across 13 regions in Saudi Arabia. Results: This study involved adult participants (18–65 years), with 45% females and 55% males. The mean age of the participants is 35 years. The participants reported the type, frequency, and quantity of caffeinated beverages consumed through a self-reported online survey. The most commonly consumed caffeinated beverages were Saudi coffee (79%), soft drinks (75%), and sweetened tea (69.3%). The highest consumption was observed in the 30–44 age group. The mean daily caffeine intake was 131 ± 1.4 mg/day (145 ± 2.3 mg/day for males, 120 ± 1.8 mg/day for females). Although female participants consumed more beverages, male participants had higher caffeine intake (p = 0.000). The mean HQ for caffeine exposure was 0.32, with a 95th percentile of 0.33, indicating no significant risk. Pregnant and lactating women’s caffeine intake also remained within safe limits. Conclusions: The average caffeine intake among Saudis is below 400 mg/day, suggesting no immediate health concerns. However, public health initiatives should focus on educating specific population groups about the safe limits of caffeine consumption. Full article
(This article belongs to the Section Tea, Coffee, Water, and Other Non-Alcoholic Beverages)
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15 pages, 727 KB  
Article
Gender Differences in Type 1 Diabetes Management and Mental Health Burden: Findings from a National Survey in Saudi Arabia
by Abdullah M. Alguwaihes
J. Clin. Med. 2025, 14(16), 5777; https://doi.org/10.3390/jcm14165777 - 15 Aug 2025
Viewed by 415
Abstract
Background: T1D is generally associated with increased psychological burden, but evidence from Middle Eastern populations remains scarce. The present study assessed the gender differences in management, prevalence, and risk factors of perceived depression and anxiety among people with T1D in Saudi Arabia. Methods: [...] Read more.
Background: T1D is generally associated with increased psychological burden, but evidence from Middle Eastern populations remains scarce. The present study assessed the gender differences in management, prevalence, and risk factors of perceived depression and anxiety among people with T1D in Saudi Arabia. Methods: A cross-sectional online survey was conducted among people withT1D across Saudi Arabia to collect demographic, clinical, and diabetes management data. Perceived depression and anxiety symptoms were assessed using a validated questionnaire. Multinomial logistic regression was used to identify risk factors of severe depression and anxiety. Results: Among 1073 PwT1D (303 males and 770 females), perceived depressive and anxiety symptoms were highly prevalent. Females had higher perceived anxiety compared with males (p = 0.003). Age- and BMI-adjusted regression analysis showed that, overall, higher income (p = 0.008), no neuropathy (p = 0.002), above-average benefit from the diabetes education clinic (p = 0.02), practicing carbohydrate counting (p = 0.002), and HbA1c < 7.0% (p = 0.01) were protective against perceived severe depression. Friends with T1D as the preferred education source (odds ratio [OR] = 2.8, p = 0.04) and a rejected request for continuous glucose monitoring (CGM) (OR = 1.88, p = 0.02) or insulin pump (OR = 2.8, p = 0.001) were significant risk factors. Perceived severe anxiety was associated with insulin pump rejection (OR = 2.4, p < 0.001) and self-reading as the preferred education source (OR = 2.0, p = 0.03). Being male (p = 0.02), no neuropathy (p = 0.01), practicing carbohydrate counting (p < 0.001), and HbA1c < 7.0% (p = 0.001) were protective. Conclusions: Symptoms of depression and anxiety are highly prevalent among people with T1D in Saudi Arabia, with females and socioeconomically disadvantaged individuals at greater risk. The findings highlight an urgent need for integrated mental health support within diabetes care and improved access to resources. Full article
(This article belongs to the Section Endocrinology & Metabolism)
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26 pages, 612 KB  
Systematic Review
Asthma Control Among Adults in Saudi Arabia: A Systematic Review and Meta-Analysis
by Mohammed M. Alqahtani, Mansour M. Alotaibi, Saeed Mardy Alghamdi, Ali Alammari, Jameel Hakeem, Fawzeah Alenazi, Nour Aldhaefi, Deema Faleh Almutairi, Ahad Adel Alghamdi and Hamdan Al-Jahdali
J. Clin. Med. 2025, 14(16), 5753; https://doi.org/10.3390/jcm14165753 - 14 Aug 2025
Viewed by 639
Abstract
Background/Objectives: Asthma is a condition caused by chronic lower airway inflammation. Its primary treatment focuses on managing the condition and reducing the frequency of exacerbation episodes. Monitoring the level of asthma control among adults is essential for both clinical care and public health [...] Read more.
Background/Objectives: Asthma is a condition caused by chronic lower airway inflammation. Its primary treatment focuses on managing the condition and reducing the frequency of exacerbation episodes. Monitoring the level of asthma control among adults is essential for both clinical care and public health planning. This systematic review aimed to assess the level of asthma control among adults in Saudi Arabia and to determine the prevalence of controlled asthma in this population. Methods: The literature search was conducted using PubMed. We included all English-language, empirical, quantitative studies that investigated the prevalence of asthma control among Saudi adults. National Institutes of Health (NIH) Study Quality Assessment Tools guided determination of the quality of the included studies. This review is registered with PROSPERO (CRD42024484711). Results: Of the 107 initially identified studies, 17 met the inclusion criteria. Quality assessment tool rated 11 studies as good, 5 as fair, and 1 as poor. Most of the included studies used cross-sectional design from different geographical locations and varied in sample size. Overall, the prevalence of uncontrolled asthma among Saudi adults ranged from 23.4% to 68.1%. In some studies, well-controlled asthma was reported in as few as 3% of patients. Factors associated with uncontrolled asthma included lower educational attainment, unemployment, low income, female gender, tobacco use, poor medication adherence, and lack of regular medical follow-up. Environmental triggers and comorbid conditions, such as allergic rhinitis, were also frequently cited as contributing factors. Conclusions: Asthma control among adults in Saudi Arabia remains a significant public health concern. Improving outcomes requires a multifaceted approach that includes patient education, regular follow-up care (including pulmonary function tests, asthma severity assessments, and personalized treatment plans), and broader public health initiatives aimed at reducing exposure to allergens and pollutants. Strengthening primary care services and implementing nationwide asthma management programs may play a critical role in enhancing disease control and improving quality of life. Continued research in this field is strongly recommended. Full article
(This article belongs to the Special Issue New Clinical Advances in Chronic Asthma)
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13 pages, 452 KB  
Article
The Association Between Physical Activity and Quality of Sleep Among Nursing Students in Saudi Arabia
by Eman Bajamal, Jori Alotaibi, Danah Balamash, Esraa Alsaeedi, Hanan Ali, Joud Alzahrani, Layan Swat, Ajwan Alamri, Raneem Jundi, Renad Alzahrani and Samar Alharbi
Healthcare 2025, 13(16), 1991; https://doi.org/10.3390/healthcare13161991 - 14 Aug 2025
Viewed by 360
Abstract
Background: Nursing students usually face excessive academic and clinical demands that negatively impact their sleep quality. Physical activity (PA) has been proposed to enhance sleep, yet few investigations have focused on this correlation within the Saudi environment. The purpose of this research was [...] Read more.
Background: Nursing students usually face excessive academic and clinical demands that negatively impact their sleep quality. Physical activity (PA) has been proposed to enhance sleep, yet few investigations have focused on this correlation within the Saudi environment. The purpose of this research was to determine the relationship between PA and sleep quality in Saudi nursing students. Methodology: A cross-sectional study was conducted among a sample of 554 nursing students from different universities in Saudi Arabia. The International Physical Activity Questionnaire–Short Form (IPAQ-SF) and the Pittsburgh Sleep Quality Index (PSQI) were used to collect data. Snowball sampling was used to recruit the participants through social media. Descriptive statistics, Pearson correlation, and inferential tests were employed for the analysis. Results: Most participants were female (85.1%) and aged 18–34 years (95.5%). LPA levels were reported by 59.6% of students, and only 8.2% engaged in VPA. The majority (91%) reported poor sleep duration (<5 h), and 57.4% had poor sleep efficiency. Overall, 86.7% of students experienced poor sleep quality. Gender and GPA were significantly associated with both PA and sleep quality. Female students and those with lower GPAs were more likely to report LPA and poor sleep. Marital status was also associated with higher levels of VPA. No significant associations were found with age, academic year, region, income, or parental education. A statistically significant positive correlation was found between PA and sleep quality (r = 0.192, p < 0.001), suggesting that increased PA is modestly associated with better sleep. Conclusion: The research shows a high rate of poor sleep and low physical activity in nursing students, indicating an alarming health trend. Although PA was linked significantly to better sleep, the modest strength indicates the necessity for multi-component interventions. Structured PA programs and sleep hygiene education should be incorporated into nursing curricula by universities to foster students’ well-being and academic performance. Full article
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15 pages, 1565 KB  
Article
Knowledge and Misconceptions About Antibiotic Use and Resistance Among Dental Clinic Visitors in Saudi Arabia—A Cross-Sectional Study
by Sarah R. Alharbi, Lama Alzamil, Zeina S. Alkudmani, Amal Alhani, Layla Faqih and Esraa Aldawood
Healthcare 2025, 13(16), 1971; https://doi.org/10.3390/healthcare13161971 - 11 Aug 2025
Viewed by 267
Abstract
Background/Objectives: Antibiotic resistance (AR) is a major public health concern, mainly driven by the misuse of antibiotics. Dental settings are one area where unnecessary antibiotic prescriptions and misconceptions among dental patients contribute significantly to antibiotic misuse. This study aimed to evaluate the [...] Read more.
Background/Objectives: Antibiotic resistance (AR) is a major public health concern, mainly driven by the misuse of antibiotics. Dental settings are one area where unnecessary antibiotic prescriptions and misconceptions among dental patients contribute significantly to antibiotic misuse. This study aimed to evaluate the knowledge and understanding of antibiotic use and AR among dental clinic visitors in Saudi Arabia. Methods: A cross-sectional survey was conducted between March and June 2024, targeting males and females aged 18 years and older residing in Saudi Arabia who visited a dental clinic within the past five years. A self-administered questionnaire was used to assess participants’ knowledge of antibiotic use and their awareness of AR. Results: A total of 1455 respondents from different regions of Saudi Arabia completed the survey. The majority of participants (70.1%) correctly identified that antibiotics kill bacteria, but around 30% incorrectly believed antibiotics treat viral infections. Additionally, 19.58% thought it was acceptable to stop taking antibiotics once they feel better. More than half of the participants thought that antibiotics reduce inflammation (69.10%) or relieve pain (52.40%). Nearly half of the participants (48.45%) were unaware of the term “antibiotic resistance (AR),” and only 27.2% identified antibiotic overuse as a cause of AR. A significant association was found between undergoing dental procedures and perceiving antibiotics as necessary (p < 0.0001). Educational level was the only significant predictor of AR awareness (AOR = 2.942; p < 0.0001). Conclusions: Although many participants correctly answered a knowledge question about antibiotics killing bacteria, several misconceptions about antibiotic use and a lack of awareness regarding AR were identified. These findings highlight the need for targeted educational interventions and enhanced antibiotic stewardship in dental practice to control AR. Full article
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23 pages, 2091 KB  
Article
Prevalence of Hearing Impairment in Saudi Arabia: Pathways to Early Diagnosis, Intervention, and National Policy
by Ahmed Alduais, Hind Alfadda and Hessah Saad Alarifi
Healthcare 2025, 13(16), 1964; https://doi.org/10.3390/healthcare13161964 - 11 Aug 2025
Viewed by 736
Abstract
Background: Hearing impairment is a significant public health issue globally, yet national data for Saudi Arabia remain sparse. Methods: Using data from the 2017 Disability Survey, we analysed 12 hearing-related indicators across 13 administrative regions. Descriptive statistics, logistic regression, cluster analysis, and residual [...] Read more.
Background: Hearing impairment is a significant public health issue globally, yet national data for Saudi Arabia remain sparse. Methods: Using data from the 2017 Disability Survey, we analysed 12 hearing-related indicators across 13 administrative regions. Descriptive statistics, logistic regression, cluster analysis, and residual mapping were applied to identify socio-demographic disparities and service gaps. Findings: Among 20,408,362 Saudi nationals, about 1,445,723 (7.1%) reported at least one functional difficulty. Of these, 289,355 individuals (1.4%) had hearing impairment, either alone or with other difficulties—229,541 (1.1%) had hearing impairment combined with other disabilities, while 59,814 (0.3%) had only hearing impairment. Females and males were equally affected. Notably, educational attainment and marital status significantly influenced device uptake; less-educated and divorced individuals were particularly underserved. Regionally, southern provinces (Al-Baha, Jazan, and Najran) demonstrated the highest unmet need due to geographic barriers, limited audiological resources, and socioeconomic constraints, reflecting compounded risks from consanguinity and rural isolation. Cluster analyses identified provinces requiring urgent attention, recommending mobile audiology units, tele-audiology services, and means-tested vouchers to enhance coverage. Conclusions: Despite Saudi Arabia’s existing public audiology services and a National Newborn Hearing Screening programme achieving 96% coverage, substantial gaps remain in follow-up care and specialist distribution, underscoring the necessity for systematic workforce tracking and enhanced rural incentives. International evidence from India and Brazil underscores the feasibility and cost-effectiveness (approximately USD 5200/QALY) of these recommended interventions. Implementing targeted provincial strategies, integrating audiological screening into routine healthcare visits, and aligning resource allocation with the WHO and Vision 2030 benchmarks will significantly mitigate hearing impairment’s health, social, and economic impacts, enhancing the quality of life and societal inclusion for affected individuals. Full article
(This article belongs to the Section Health Informatics and Big Data)
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17 pages, 269 KB  
Article
Patterns and Factors Associated with E-Cigarette Initiation and Transition Among University Students in Al-Madinah City, Saudi Arabia: A Cross-Sectional Study
by Shahad Mubarak Alahmadi and Abdulmohsen Hamdan Al-Zalabani
Healthcare 2025, 13(16), 1949; https://doi.org/10.3390/healthcare13161949 - 9 Aug 2025
Viewed by 384
Abstract
Background/Objectives: Electronic cigarettes (e-cigarettes) have gained popularity among young adults globally, but only limited research exists on usage patterns in Saudi Arabia. This study investigated the prevalence, patterns, and factors associated with e-cigarette use initiation and transition to cigarette smoking among university [...] Read more.
Background/Objectives: Electronic cigarettes (e-cigarettes) have gained popularity among young adults globally, but only limited research exists on usage patterns in Saudi Arabia. This study investigated the prevalence, patterns, and factors associated with e-cigarette use initiation and transition to cigarette smoking among university students in Saudi Arabia. Methods: A cross-sectional survey was conducted among 537 university students in Al-Madinah city during the 2024–2025 academic year. Data were collected using a self-administered online questionnaire assessing e-cigarette use patterns, motivations, susceptibility to future cigarette smoking, and demographic characteristics. Multivariable logistic regression analysis was used to identify factors associated with e-cigarette use. Results: E-cigarette prevalence was substantial: 11.7% of participants were current users, 5.4% were former users, and 27.9% were ever-users, compared with 5.8% current cigarette smokers. Males had significantly higher use rates than females (20.9% vs. 4.6%; p < 0.001). Senior students showed the highest current use (21.1%). Among ever-users, the primary motivations were enjoyment (29.3%), the possibility of use where smoking is banned (26.1%), and social acceptability (21.7%). Most users (73.0%) used high-nicotine liquids (≥20 mg/mL), and 55.4% vaped daily. Multivariable logistic regression revealed that e-cigarette use was independently associated with male gender (adjusted OR = 4.0), higher academic year (OR = 1.24), current smoking (adjusted OR = 3.45; 95 CI: 1.54–7.82), and lower harm perception (adjusted OR = 1.69; 95 CI: 1.16–2.51). Susceptibility to future cigarette smoking was 18.9% overall but much higher among current e-cigarette smokers (59.5%; p < 0.001). Conclusions: E-cigarette use was prevalent among Saudi university students, particularly males and senior students, with patterns suggestive of nicotine dependence. Strong associations with cigarette smoking and high-concentration nicotine use raise concerns about dual use and addiction potential. Full article
20 pages, 542 KB  
Review
Stress, Anxiety, and Depression as Psychological Distress Among College and Undergraduate Students: A Scoping Review of Reviews Guided by the Socio-Ecological Model
by Sharmistha Roy, Ashis Kumar Biswas and Manoj Sharma
Healthcare 2025, 13(16), 1948; https://doi.org/10.3390/healthcare13161948 - 9 Aug 2025
Viewed by 675
Abstract
Background/Objectives: College and undergraduate students around the world struggle with stress, anxiety, and depression, which have a significant negative influence on their academic performance, social interactions, and general well-being. Creating successful preventative and intervention plans requires an understanding of the many, multi-level [...] Read more.
Background/Objectives: College and undergraduate students around the world struggle with stress, anxiety, and depression, which have a significant negative influence on their academic performance, social interactions, and general well-being. Creating successful preventative and intervention plans requires an understanding of the many, multi-level factors that contribute to psychological discomfort. The objective of this scoping review was to use the Socio-Ecological Model (SEM) to map the determinants of psychological distress among college students in a comprehensive manner. Methods: A total of 15 review publications published between 2015 and 2024, including narrative reviews, systematic reviews, meta-analyses, and umbrella reviews, were analyzed under the guidance of PRISMA ScR. These studies synthesized evidence across various countries, including China, Iran, India, Canada, Egypt, Nigeria, Saudi Arabia, and the United States. Results: Academic pressure, financial stress, poor sleep, unhealthy coping mechanisms, and pre-existing mental health issues were all individual-level concerns, with female and minority students being more vulnerable. Strong familial ties and friendships served as protective interpersonal support. Heavy academic workloads, strict grading guidelines, a lack of mental health resources, and unwelcoming campus environments were among the institutional factors. Stigma and socioeconomic disparities are examples of community-level variables that make mental health issues worse. Conclusions: Student mental health is shaped by interrelated factors across all SEM levels. Integrated, multi-level strategies are essential to fostering supportive campuses, strengthening community networks, and implementing inclusive policies that promote mental health equity. Full article
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13 pages, 504 KB  
Article
Fear of Falling After Total Knee Replacement: A Saudi Experience
by Turki Aljuhani, Jayachandran Vetrayan, Mohammed A. Alfayez, Saleh A. Alshehri, Mohmad H. Alsabani, Lafi H. Olayan, Fahdah A. Aljamaan and Abdulaziz O. Alharbi
Clin. Pract. 2025, 15(8), 146; https://doi.org/10.3390/clinpract15080146 - 6 Aug 2025
Viewed by 445
Abstract
Background: Fear of falling (FOF) is a significant concern among older adults, especially after total knee arthroplasty (TKA). FOF can limit daily activities, reduce quality of life, and hinder recovery. This study aimed to investigate the prevalence, severity, and impacts of FOF [...] Read more.
Background: Fear of falling (FOF) is a significant concern among older adults, especially after total knee arthroplasty (TKA). FOF can limit daily activities, reduce quality of life, and hinder recovery. This study aimed to investigate the prevalence, severity, and impacts of FOF in patients undergoing TKA and identify factors contributing to increased FOF. Methods: A prospective observational study was conducted at King Abdulaziz Medical City in Riyadh, Saudi Arabia, from April 2024 to December 2024. This study included 52 participants aged 20 to 75 years who had undergone primary TKA. Data were collected at two time points: after TKA and at three months post-surgery. The Short Falls Efficacy Scale-International (SFES-I) was used to assess the severity of FOF, and the Short Form 36 (SF-36) was used to measure the quality of life. Descriptive statistics, t-tests, and logistic regression were used for analysis. Results: This study included 52 participants (mean age: 63.77 ± 6.65 years; 82.7% female). Post-TKA, all participants exhibited high FOF (mean SFES-I score: 56.75 ± 8.30). After three months, the mean SFES-I score decreased significantly to 49.04 ± 12.45 (t = 4.408, p < 0.05). Post-TKA, SF-36 showed significant improvements in the physical function, role of physical limitations, bodily pain, vitality, social function, role of emotional limitations, and mental health subdomains. Bilateral total knee arthroplasty, body mass index, and some SF-36 subcomponents—such as general health, vitality, and role of emotional limitations—were identified as factors leading to increased FOF. Conclusions: FOF remains prevalent and severe in TKA patients, even at three months post-surgery, affecting rehabilitation outcomes. Early identification and tailored interventions for FOF should be considered essential components of comprehensive TKA recovery programs. Full article
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16 pages, 2218 KB  
Article
The Effectiveness of Semaglutide on a Composite Endpoint of Glycemic Control and Weight Reduction and Its Effect on Lipid Profile Among Obese Type 2 Diabetes Patients
by Sumaiah J. Alarfaj
Medicina 2025, 61(8), 1393; https://doi.org/10.3390/medicina61081393 - 31 Jul 2025
Viewed by 405
Abstract
Background and Objectives: Obesity and type 2 diabetes (T2D) are closely linked and associated with a higher risk of complications. This study aims to evaluate the effectiveness of once-weekly semaglutide in achieving a composite endpoint of A1C and weight reduction. Materials and Methods: [...] Read more.
Background and Objectives: Obesity and type 2 diabetes (T2D) are closely linked and associated with a higher risk of complications. This study aims to evaluate the effectiveness of once-weekly semaglutide in achieving a composite endpoint of A1C and weight reduction. Materials and Methods: This retrospective cohort study assessed the effectiveness of semaglutide in obese patients with T2D at a tertiary care hospital in Saudi Arabia. This study included patients who received semaglutide treatment for 12 months, and the endpoint was reducing A1C by ≥ 1% and body weight by ≥ 5% after 12 months of starting semaglutide. Secondary endpoints include predictors of achieving the composite endpoint and the effect on the lipid profile. Results: The present study enrolled 459 participants, with dyslipidemia and hypertension being the most common comorbidities. After 12 months of treatment with semaglutide, 42% of the patients achieved the composite endpoint. Semaglutide significantly reduced weight, BMI, A1C, FBG, total cholesterol, LDL, and triglycerides. The subgroup analysis showed that patients who achieved the composite endpoint were younger and had significantly lower use of insulin. Females in the study had significantly higher BMI, A1C, and HDL levels and lower levels of triglycerides compared to males. Multivariate analysis revealed that baseline BMI (aOR = 0.953; 95% CI: 0.915 to 0.992; p = 0.02), baseline A1C (aOR = 1.213; 95% CI: 1.062 to 1.385; p = 0.004), and receiving insulin (aOR = 0.02; 95% CI: 0.001 to 0.343; p = 0.007) were significant predictors of composite endpoint achievement. Conclusions: Semaglutide is a valuable option for the treatment of obese patients with T2D. This study found that semaglutide is effective in reducing weight and A1C and improving the lipid profile. The predictors of achievement of the composite endpoint were lower baseline BMI, higher baseline A1C, and insulin non-use. Full article
(This article belongs to the Special Issue Clinical Management of Diabetes and Complications)
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Article
Prevalence and Impact of Antidepressant and Anti-Anxiety Use Among Saudi Medical Students: A National Cross-Sectional Study
by Daniyah A. Almarghalani, Kholoud M. Al-Otaibi, Samah Y. Labban, Ahmed Ibrahim Fathelrahman, Noor A. Alzahrani, Reuof Aljuhaiman and Yahya F. Jamous
Healthcare 2025, 13(15), 1854; https://doi.org/10.3390/healthcare13151854 - 30 Jul 2025
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Abstract
Background: Mental health issues among medical students have gained increasing attention globally, with studies indicating a high prevalence of psychological disorders within this population. The use of antidepressants and anti-anxiety medications has become a common response to these mental health challenges. However, it [...] Read more.
Background: Mental health issues among medical students have gained increasing attention globally, with studies indicating a high prevalence of psychological disorders within this population. The use of antidepressants and anti-anxiety medications has become a common response to these mental health challenges. However, it is crucial to understand the extent of their usage and associated effects on students’ mental health and academic performance. This cross-sectional study explored the use of antidepressants and anti-anxiety drugs and their impact on the mental health of medical students in Saudi Arabia. Methods: A cross-sectional survey of 561 medical students from 34 universities was conducted between March and July 2024. An anonymous online questionnaire was used to collect sociodemographic, mental health, and medication usage-related information. Results: Most of the participants were female (71.5%) and aged 21–25 years (62.7%). Approximately 23.8% of them used antidepressants, 5.6% reported using anti-anxiety medications, and 14.0% used both types of medication. Among the medication users, 71.7% were using selective serotonin reuptake inhibitors (SSRIs), and 28.3% were using other medications. Adverse drug reactions were reported by 58.8% of the participants, and 39.6% changed drugs with inadequate efficacy. Notably, 49.0% of the respondents who have ever used medications discontinued their medication without consulting a healthcare professional. Despite these challenges, 62.0% of the participants felt that their medications had a positive impact on their academic performance, 73.4% believed that the benefits outweighed the drawbacks, and 76.2% expressed a willingness to continue taking their medication. In particular, 77.6% agreed that treatment with these drugs could prevent mental breakdowns. Sleep duration, physical activity, and family history of psychiatric disorders were significantly associated with medication use, with p values of 0.002, 0.014, and 0.042, respectively. Conclusions: These results shed light on the need to understand the prescribing practices of antidepressant and anti-anxiety drugs among medical students while promoting the appropriate use of these medications among the students. There is a need to incorporate mental health interventions into counseling services and awareness programs to support students. Future longitudinal studies are needed to explore long-term trends. Full article
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