In this second issue of the year various topics of interest to primary care are discussed.

Bakkar, et al discussed the Role of Ultrasound in Poly Cystic Ovaries Assessment. They stressed that Polycystic ovarian syndrome (PCOS) is the most common endocrine abnormality in women of reproductive age and carries with it significant health risks, including infertility, endometrial hyperplasia, diabetes, and cardiovascular disease. The workup of PCOS has evolved to include the use of pelvic ultrasonography (US). Since patients are frequently referred for radiologic imaging as a part of clinical workup, and polycystic ovaries are a common incidental finding in women undergoing US for other gynecologic complaints, radiologists should be aware of the current diagnostic criteria for PCOS, the role of imaging in workup for this abnormality, and the pertinent reporting parameters for pelvic US.

Bin Abdulrahman, et al., did a cross-sectional study was conducted among secondary and high school students in Riyadh, Saudi Arabia. The study was conducted among 901 students from different schools in the Riyadh region who were randomly included using a questionnaire distributed online. The prevalence of acne among students was 57.4 % among students. According to the Cardiff Acne Disability Index, 19.4 % of patients with acne had a high disability, 40.1 % had a moderate disability, and 40.5 % had a low disability. The index score ranged in this study from 0 (16 patients showed a score of zero with a percent of 3.1%) to 15 (16 patients showed a score of 15 with a percent of 3.1%) with a mean score of 6.15 (standard deviation=3.79). The authors concluded that this study confirmed the results of previous studies that acne causes the quality of life disabilities among school-age students. Our study showed a high prevalence of acne among students with a more significant negative impact than previous studies.

Alsumairi 1, et al., tried to assess the knowledge and practice of foot care among diabetic patients attending primary healthcare centers. They followed a cross sectional study was conducted in Taif city, among adult diabetic patients attending the primary health care centers, belonging to Ministry of health during the proposed study period from February to May 2022. A total of 385 diabetic patients were included in the study. Their age ranged between 14 and 75 years with an arithmetic mean of 40.6 and standard deviation of 13.2 years. The authors concluded that relative suboptimal level of both knowledge and practice related to foot care was observed. Educational programs including practical sessions, better through using videos regarding the best practice of foot care are highly recommended for diabetic patients.

Alhujaili, et al.,. did a cross-sectional study to assess the prevalence of SAD among the medical students at King Abdulaziz University- Rabigh branch and its associated risk factors. The study was conducted on 218 students aged between 18 and 26, which was managed by sending an online questionnaire that included participants’ demographic information and The Liebowitz Social Anxiety Scale (LSAS). SAD is found to be significantly common among the participating medical students and correlated positively with multiple relevant factors, showing the effort needed for earlier detection of SAD to manage it accordingly.

Alkhalid et al., attempted to find the correlation between pseudoscience practices and depression among pseudoscience believers in Saudi Arabia. They did a cross-sectional study conducted among the Saudi population who believe in pseudoscience. Of the 409 believers, 41.8% were aged between 26 – 35 years old with females being dominant (94.5%). The most prominent practice of reading was Zodiac (81.3%). The authors concluded that there was a high prevalence of depression among pseudoscience believers. Increased depression was demonstrated more frequently by younger believers who were still single, less educated, and who were currently engaged in Zodiac reading practices. More research is needed to shed more light on the effect of pseudoscience on the mental health condition of its believers.

Alghanem et al., did a systemic review to search, analyze and identify evidence regarding the use of physical activity interventions in preventing type 2 diabetes mellitus (T2DM) in prediabetic population. This systematic review shows that most of the physical activity interventions are effective and this leaves the healthcare providers to choose one that will show to be more effective. Because of the reported effectiveness, the HIIT programs can prove to be the better choice.

Alghamdi., et al., did a descriptive cross-sectional study; conducted among healthcare professionals working at ICUs at King Fahad Hospital and Prince Meshari Hospital,. A convenient sampling technique was used to collect data using questionnaire about knowledge attitude and practice towards chest physiotherapy for Covid-19 patients which was adopted from previous validated questionnaire. This study aimed to assess the knowledge, attitude, and practice of the health

care professionals in chest physiotherapy for COVID-19 patients. This study highlighted that majority off healthcare providers (physiotherapists, nurses or medical) are knowledgeable, they also have positive attitude and appropriate practices about COVID-19 physiotherapy management in ICUs at Al-Baha governmental hospitals.

Aljuaid, et al., did a retrospective observational cohort study of COVID-19 patients admitted in two tertiary hospitals in Saudi Arabia from May to July 2020. Patients’ demographics, comorbidities and clinical manifestations were collected from the medical records. The aim of this study is to determine the obesity risk factors among hospitalized COVID-19 patients and their influence on the clinical outcomes of the disease Out of 260 patients who were included in the study, 41.6% were obese. The authors concluded that obesity is very common among hospitalized patients with Covid-19 particularly females. Obese Patients were more likely to have cardiovascular risk factors and adverse clinical outcomes.

Bin Abdulrahman, et al., did a quantitative study is a descriptive cross-sectional study conducted among medical students in different universities in Riyadh region. the
main aim of this study is to assess the mental health of medical students in different levels of training to see if a certain level plays a higher role in developing mental health issues. In the current study, we collected data from 617 medical students from four universities in Riyadh region, Saudi Arabia. Among the students, 56.7 % of the participants were males, and 42.1 % were aged between 20-21 years old, and 91.6 % of them were single. According to the GHQ-12, 368 students were classified as GHQ- cases having symptoms of depression and psychiatric disorders (59.6 %). The prevalence of psychological distress among female students was significantly higher than among males (68.9 % vs. 52.6 %, P=0.000).
The authors concluded that the current study confirmed the previous studies on the high prevalence of psychological distress among medical students, which was significantly higher among females, students of low income, and students with lower GPAs. Moreover, the study showed that first-level students were the most affected by psychological distress.

Helvaci, et al., tried to understand whether or not there is a relationship between smoking and diabetes mellitus (DM). Current regular smokers for the last six months and age and sex-matched non-smokers were included. Patients with current alcohol consumption (one drink a day) and patients with malignancies or inflammatory, infectious, or devastating disorders were excluded. The study included 247 smokers and 167 non-smokers. The mean age and body mass index (BMI) of smokers were 46.2 years and 26.6 kg/m2, respectively, and 70.0% of them were male. The authors concluded that smoking-induced low-grade inflammation on vascular endothelium in whole body may terminate with the endothelial dysfunction, accelerated atherosclerosis, end-organ insufficiencies, early aging, and premature death. FPG and HDL may be negative whereas triglycerides, LDL, ESR, and CRP positive acute phase reactants terminating with lower prevalence of DM but higher incidence of dyslipidemia in smokers.

Mobarki, et al., reviewed Methicillin-Resistant Staphylococcus Aureus Combination Treatment Options in Vivo and in Vitro. The authors stressed that the spread of multidrug-resistant Staphylococcus aureus continues to threaten global health. Methicillin-resistant Staphylococcus aureus (MRSA) is one of common causes of bacterial infections in hospitals and communities. Despite vancomycin being an effective treatment for MRSA, from 2006 to 2020, vancomycin-resistant MRSA increased 3.5-fold, from 5% to 7%. Bacterial genome mutations, as well as bacteria’s ability to transfer genetic material with other bacteria, allowing them to obtain resistance genes from different strains, are all factors contributing to the development of vancomycin resistance in MRSA. As a result, combination therapy may be a potential treatment for MRSA infection. We searched in PubMed and Google Scholar, and our search yielded 92 articles, out of which 74 full-text articles were reviewed and 56 were selected for this study. This literature review examines combination therapies for MRSA infections. Such as -Lactams with vancomycin, linezolid and imipenem, daptomycin and ceftaroline. The review yielded several studies looking at the synergy between -lactams and vancomycin. Although linezolid and rifampicin demonstrate synergy against MRSA in vivo and in vitro in various invasion diseases, more clinical research is required to prove their efficacy. Furthermore, daptomycin plus ceftaroline shows synergy for refractory staphylococcal bacteremia in vivo and in vitro. Combining ceftaroline and daptomycin has two benefits: they work synergistically together and make the innate host defense peptide cathelicidin leucine-leucine-37 (LL-37) more sensitizing. Ceftaroline plus daptomycin was recently used in MRSA biofilm infections, demonstrating a potentially promising treatment as the first combination used without side effects in humans.