Mutations have driven the evolution and development of new variants of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with potential implications for increased transmissibility, disease severity and vaccine escape among others. Genome sequencing is a technique that allows scientists to read the genetic code of an organism and has become a powerful tool for studying emerging infectious diseases. Here, we conducted a cross-sectional study in selected districts of the Eastern Province of Zambia, from November 2021 to February 2022. We analyzed SARS-CoV-2 samples (n = 76) using high-throughput sequencing. A total of 4097 mutations were identified in 69 SARS-CoV-2 genomes with 47% (1925/4097) of the mutations occurring in the spike protein. We identified 83 unique amino acid mutations in the spike protein of the seven Omicron sublineages (BA.1, BA.1.1, BA.1.14, BA.1.18, BA.1.21, BA.2, BA.2.23 and XT). Of these, 43.4% (36/83) were present in the receptor binding domain, while 14.5% (12/83) were in the receptor binding motif. While we identified a potential recombinant XT strain, the highly transmissible BA.2 sublineage was more predominant (40.8%). We observed the substitution of other variants with the Omicron strain in the Eastern Province. This work shows the importance of pandemic preparedness and the need to monitor disease in the general population.

OBJECTIVE: To determine and compare the prevalence of attention deficit hyperactivity disorder (ADHD) symptoms among male and female medical students in the Eastern Province of Saudi Arabia and evaluate the effect of ADHD on the academic performance of the affected medical students.
METHODS: This cross-sectional study measured the prevalence of adult ADHD symptoms among medical students in the Eastern Province of Saudi Arabia. A total of 354 Saudi medical students from King Faisal University, Al-Ahsa, and Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia, participated in a self-reported questionnaire. The questionnaire was distributed on different social media platforms from December 2021 to April 2022.
RESULTS: Among the study participants, 26% exhibited symptoms highly consistent with adult ADHD. Young age (<20 years, p=0.049) and non-marital status (p=0.048) were associated with a higher rate of ADHD symptoms with recorded statistical significance. Additionally, there is no significant association between grade point average and adult ADHD (p=0.560).
CONCLUSIONS: The study demonstrated a higher prevalence of adult ADHD among medical students in the Eastern Province than the reported rates locally and globally. This could be attributed to social and cultural factors, as well as the chosen method for assessing the symptoms of Diagnostic and Statistical Manual items.

UNASSIGNED: Studying mental disorders in children is significantly important due to the huge suffering of educational and psychosocial impairments in adult life. Attention-deficit/hyperactivity disorder (ADHD) is considered the most common mental disorder in children, especially in early school-aged children. It manifests in about 8%-12% of children in the world. In Saudi Arabia, it affects 4%-12% of children.
UNASSIGNED: The study aimed to count the number of undiagnosed ADHD cases and the associated risk factors in Eastern Province in Kingdom of Saudi Arabia (KSA).
UNASSIGNED: A cross-sectional study was performed among girls\' and boys\' children aged 6-10 years old in Eastern Province in KSA with a random selection of parents. Sample size is equal to 1658. The assessment was done by an online questionnaire filled it by parents using Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnostic criteria and Connor\'s scale of ADHD excluding any developmental or mental disorder at the beginning of the questionnaire.
UNASSIGNED: After excluding the participants who were diagnosed with behavioral and growth developmental disorder, the remaining 1430 have been screened for ADHD based on Connor\'s scale. 185 of a child out of 1430 were suggested to have ADHD, of which 10 out of them show the signs of ADHD, 76 of them have moderately severe ADHD, and 99 out of them have atypical or severe ADHD based on Connor\'s scale of ADHD. The study shows that there is a significant relationship between the positive screening of ADHD and gender males (71.35%), females (28.64%), family history (20.5%), nervous system diseases (4.32%), brain damage from trauma (9.72%), smoking habit of the mother (8.64%), smoking during pregnancy (3.78%), mother exposure to second-hand smoking (42.16%), child exposure to a toxic substance like lead during the early life (1.62%), and the preterm labor (15.13%). However, the study shows there is no significant relationship between the positive screening of ADHD with age, drinking alcohol, and central nervous system infection.
UNASSIGNED: The prevalence of undiagnosed ADHD is slightly high. Also, it has many causes of ADHD including gender, smoking, parental psychiatric disorders, and obstetric and pregnancy problems.
Résumé Background: L\'étude des troubles mentaux chez les enfants est d\'une importance considérable en raison des souffrances liées aux difficultés scolaires et psychosociales qui perdurent à l\'âge adulte. Le trouble du déficit de l\'attention avec hyperactivité (TDAH) est considéré comme le trouble mental le plus courant chez les enfants, notamment chez les enfants d\'âge scolaire précoce. Il se manifeste chez environ 8% à 12% des enfants dans le monde. En Arabie saoudite, il touche entre 4% et 12% des enfants. Objective: L\'étude visait à dénombrer le nombre de cas de TDAH non diagnostiqués et les facteurs de risque associés dans la province orientale du Royaume d\'Arabie saoudite (KSA). Methods: Une étude transversale a été réalisée auprès d\'enfants de filles et de garçons âgés de 6 à 10 ans dans la province orientale de l\'Arabie saoudite, en utilisant une sélection aléatoire des parents. La taille de l\'échantillon est égale à 1658. L\'évaluation a été réalisée à l\'aide d\'un questionnaire en ligne rempli par les parents, en utilisant les critères diagnostiques du Manuel diagnostique et statistique des troubles mentaux, cinquième édition, ainsi que l\'échelle de Connor pour le TDAH, en excluant tout trouble du développement ou trouble mental au début du questionnaire. Résultats: Après exclusion des participants ayant été diagnostiqués avec un trouble du comportement et du développement, les 1430 restants ont été dépistés pour le TDAH à l\'aide de l\'échelle de Connor. Parmi ces enfants, 185 ont été suggérés d\'avoir un TDAH, dont 10 présentent des signes de TDAH, 76 présentent un TDAH modérément sévère et 99 présentent un TDAH atypique ou sévère selon l\'échelle de Connor. L\'étude révèle qu\'il existe une relation significative entre le dépistage positif du TDAH et le genre masculin (71,35 %), féminin (28,64 %), les antécédents familiaux (20,5 %), les maladies du système nerveux (4,32 %), les lésions cérébrales suite à un traumatisme (9,72 %), la consommation de tabac par la mère (8,64 %), la consommation de tabac pendant la grossesse (3,78 %), l\'exposition de la mère à la fumée secondaire (42,16 %), l\'exposition de l\'enfant à une substance toxique comme le plomb pendant la petite enfance (1,62 %) et le travail prématuré (15,13 %). Cependant, l\'étude montre qu\'il n\'existe aucune relation significative entre le dépistage positif du TDAH et l\'âge, la consommation d\'alcool et les infections du système nerveux central. Conclusion: La prévalence du TDAH non diagnostiqué est légèrement élevée. De plus, il existe de nombreuses causes du TDAH, dont le genre, le tabagisme, les troubles psychiatriques des parents, ainsi que les problèmes obstétriques et durant la grossesse. Mots-clés: Attention, trouble du déficit de l\'attention/hyperactivité, Province orientale, hyperactivité, Royaume d\'Arabie saoudite.

Objectives The objective of this study is to assess the effects of alopecia on quality of life, depression, and self-esteem in the Eastern Province of Saudi Arabia. Methods We made a questionnaire that included sociodemographic data, type of alopecia, medical aid sought, and whether they benefited from it or not. The study uses the Dermatology Life Quality Index, Patient Health Questionnaire-9, and a single-item self-esteem scale to assess the quality of life, depression, and self-esteem, respectively. Results The questionnaire was completed by 403 individuals in total, and after applying the exclusion criteria (only Saudis, from the Eastern Province), 231 participants were included in this study. Of the participants, 49.4% had hereditary baldness and only 9.5% benefited from treatment. Of the patients, 52.4% had higher levels of depression, and 18.2% had an effect on their life. Patients with a moderate or greater effect on their lives had a significant relationship with hereditary baldness. Younger age, being female, being married, having lower income, and having hereditary baldness were significantly associated with higher depression levels (p = <0.05). The study found that as age increased, depression levels decreased and self-esteem scores increased. Depression was linked to lower quality of life, while self-esteem was linked to both lower quality of life and higher depression levels. These factors are interrelated, with age influencing their relationship. Conclusions The results of the study highlight the significant occurrence of depression and decreased quality of life among patients who have alopecia, particularly those with hereditary baldness. It is crucial to provide psychological assistance and counseling to enhance their mental health and overall wellness.

Introduction Breast cancer is the leading type of cancer in women globally, contributing significantly to cancer-related deaths. In Saudi Arabia, it ranks as the second most common cancer among women. Studies have highlighted a lack of awareness about breast cancer, negatively impacting breast self-examination practices. The Eastern Province has particularly high incidence rates. Knowledge of risk and protective factors can aid in prevention and early detection. While some studies show good awareness, this research aims to assess women\'s knowledge and attitudes about breast cancer risk factors and warning signs in the Eastern Province. Methodology This is a cross-sectional study conducted in Saudi Arabia\'s Eastern Province from June to October 2023 to assess breast cancer awareness among adult females. Data were collected via an online survey. Data were cleaned in MS Excel (Microsoft Corporation, Redmond, Washington) and analyzed in IBM SPSS Statistics for Windows, Version 23 (Released 2015; IBM Corp., Armonk, New York). Results Our study assessed breast cancer awareness in 697 participants in Saudi Arabia\'s Eastern Province. Most were aged 20-24 years (30.3%), married (49.2%), and Saudi nationals (97.6%), with higher education (59.4%). Significantly, 69.2% received education on breast cancer risk factors/signs. Some had personal breast cancer diagnoses (5.0%), and 31.7% had affected family members. Participants showed good awareness of various risk factors and warning signs. Significant associations were found between nationality, personal breast cancer diagnosis, and knowledge and attitudes about risk factors. Age, marital status, occupation, education on breast cancer, and personal breast cancer diagnosis influenced knowledge and attitudes about warning signs. Conclusion Our study findings indicate generally good awareness of breast cancer risk factors and warning signs among participants. Age, marital status, occupation, education on breast cancer, and personal breast cancer diagnosis influenced knowledge and attitudes about risk factors and warning signs. Educational efforts should target lesser-known risk factors to enhance prevention and early detection.

Background Dry eye syndrome (DES), also known as keratoconjunctivitis sicca (KCS), is a common cause of patient\'s visits to the ophthalmologist. It is characterized by a defect in the tear film homeostasis, symptoms of ocular discomfort, and visual disturbance. Also, it increases the risk of ocular surface damage if complicated by tear film hyperosmolarity and ocular surface inflammation. The present study aims to measure awareness about dry eye disease and the risk factors among the Eastern region population in Saudi Arabia via an online questionnaire. Methods This is a cross-sectional community-based study conducted in Saudi Arabia that assessed knowledge and awareness of dry eye among the eastern province population using a self-administered online questionnaire. The minimum sample size was 385 adults. Statistical analysis was performed using SPSS software, version 21.0 (IBM Corp., Armonk, NY), and participants\' overall awareness level was evaluated based on correct answers. Results In this study, a total of 522 participants fulfilling the inclusion criteria completed the study questionnaire. Participants ranged from 18 to 65 years, with a mean age of 27.2 ± 14.6 years old. Females represented a higher percentage of the sample, 341 (65.3%). Public awareness regarding dry eye diseases in the Eastern region, Saudi Arabia of 149 participants (28.5%) is overall a good awareness level while 373 (71.5%) of them had poor awareness. Conclusion Participants showed unsatisfactory results in awareness of risk factors of dry eye symptoms, where the most reported causes were prolonged concentration while using electronic devices, climatic factors, and lacrimal gland disorders.

BACKGROUND: According to the World Breastfeeding Trends Initiative, Sri Lanka ranked as number one and only country to achieve green status. Exclusive breastfeeding (EBF) for six months is current practice with a rate of 75.5% among 0-5 months.
OBJECTIVE: Identify factors contributing early cessation of breastfeeding in a single centre of Eastern province Sri Lanka.
METHODS: A descriptive cross-sectional study conducted in Sammanthurai Medical officer of Health area. Consecutive mother-infant days with the infant ageing < 6 months were included from 25 public health midwife areas using an interviewer administered questionnaire. Missing values imputed using \'missForest\' algorithm.
RESULTS: The mean age of the sample was 28.4(SD ± 5.6). Of the 257 mothers recruited, 15(5.8%) were teenagers and 42(16.3%) > 35 years. 251(97.6%) had children 1-5 and 86(33.5%) were first born. 140 (54.5%) had tertiary education, 28 (10.9%).31(12.1%) were employed. EBF rates 0-6 months was 79.8% (n = 205). 239(93.0%) started breastfeeding within an hour. EBF was not associated with maternal age, birth order or income. 18 employed mothers and 186 unemployed mothers continued EBF. Regarding the factors associated with EBF, having a tertiary education (p < .001), being employed (p = .004) and having less than 3 children (p = .03) were associated with non-exclusive breastfeeding. Tertiary education was the significant predictor of non-exclusive breastfeeding in this population with an odds ratio of 4.50 (95% CI 1.331-15.215).
CONCLUSIONS: Employment identified as a risk factor for early cessation of EBF needs well planned further research to overcome this practical issue. Also might need revision of workplace policies, establishment of lactation areas in office premises to overcome some of these issues.

BACKGROUND: Epilepsy is one of the most common neurological disorders among patients, with a high prevalence in adults and children in Saudi Arabia. It can have a negative impact on a child\'s health, behavior, and academic performance, as well as their mental health. As a seizure attack can happen in school and the teachers will be the first health providers, preventing complications and ensuring student performance, development of social skills, and future employment can be significantly impacted by a teacher\'s awareness and attitudes towards epilepsy.
METHODS: A descriptive cross-sectional study was conducted in Eastern Province, Saudi Arabia, targeting teachers in schools of all educational levels using a self-administrated validated questionnaire in Arabic. A total of 423 teachers fulfilling the inclusion criteria were included. Teachers\' ages ranged from 18 to more than 50 years with mean age of 42.6 ± 9.3 years old. Exactly 261 (61.7%) teachers were females and 400 (94.6%) were Saudi.
RESULTS: We defined acceptable level of awareness as the ability to recognize seizure phenomena (if they have witnessed one before) as a medical neurological problem (as opposed to attributing it to religious and/or superstitious beliefs, etc.) with ability to respond promptly with proper first aid required when encountering a seizure (turn on one side, avoid placing items in mouth, etc). Exactly 163 (38.5%) had good overall knowledge level while 260 (61.5%) had poor knowledge regarding epilepsy.
CONCLUSIONS: Our research found that teachers have poor knowledge about epilepsy, wherein 38.5% had good overall knowledge level while 61.5% had poor knowledge regarding epilepsy. However, only a 9.2% had first-aid training, which suggests that knowledge and practice of epilepsy first aid needs to be improved via public awareness campaigns and first-aid training courses in schools.

Background and objective Work-related musculoskeletal diseases (WMSDs) are one of the most common occupational health concerns among teachers. They refer to a variety of degenerative and inflammatory disorders that can be triggered by the work environment of the people affected. Teachers\' health is substantially significant as it impacts their productivity at work. The aim of this study was to determine the prevalence, patterns, implications, and risk factors of WMSDs among teachers in the Eastern Province of Saudi Arabia. Methods This study involved a survey based on a cross-sectional questionnaire that was distributed to 404 random school teachers located in the Eastern province of Saudi Arabia. Information such as sociodemographic characteristics, workplace characteristics, characteristics of WMSDs experienced, associated factors, and impact of the symptoms experienced was collected. Questions related to symptoms were obtained from the Nordic Musculoskeletal Questionnaire and Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ). The collected data were then analyzed using the SPSS Statistics version 23.0 (IBM Corp., Armonk, NY). Results Among the participants, back pain, shoulder pain, and knee pain were the most reported symptoms of WMSDs in the past 12 months, while elbow pain was the least experienced; 41.1% had pain, discomfort, or numbness that prevented them from performing regular daily activities. The regression analysis revealed a relationship between moderate to severe pain and a pain duration of more than 12 months (p=0.001). Additionally, those who were able to perform lighter work and were not having depression had a low probability of pain persistence and were able to carry out their usual work while experiencing pain (p=0.002). Conclusions In the Eastern province of Saudi Arabia, WMSDs were commonly reported by school teachers. The prevalence of WMSDs among teachers was 41.1%. The pain was described as disabling and causing a negative impact on performance. The most common locations of symptoms were the back, shoulder, and knees. Risk factors for severe pain were female gender, sleeping for six to seven hours, and pain located in the neck shoulder, elbow, hand, thigh/hips, back, knees, and ankles. Furthermore, severe pain was associated with pain duration of more than 12 months, affecting sleep, causing anxiety, and mild depression. The impact of severe pain seriously affected the daily activities of teachers.

UNASSIGNED: Goat farming significantly contributes to the efficient use of land and socioeconomic development in developed and developing countries. During the fiscal year 2017-2018, goats made up 13.5% of the total live livestock exported by Rwanda. Gastrointestinal parasites (GIPs) can negatively impact goat production, especially in developing countries like Rwanda. This study aimed to determine the impact of the goat\' age and location (administrative cell) on the prevalence of gastrointestinal nematodes, cestodes, and protozoans (GiNCPs) of goats in Nyagatare district, Rwanda.
UNASSIGNED: In this cross-sectional study, 149 faecal samples were collected from apparently unwell goats and analyzed using the simple flotation technique. Strongyle-type nematodes (STNs) infections were graded using the McMaster method. Pearson chi-square tests of independence were calculated to assess the impact of the goat\' age and location on the prevalence of GiNCPs in the study area.
UNASSIGNED: All the goats (100%) were infected with GiNCPs. The identified types of parasites were STNs (96.0%), Coccidia (83.2%), Moniezia spp (14.8%), Strongyloides papillosus (12.8%), Nematodirus spp (0.7%) and Trichuris ovis (0.7%). Nearly 85.9% (128/149) of the goats were coinfected with 2 to 4 types of parasites and the coinfection of STNs and coccidia preponderated at 58.4%. The location (administrative cell) of the goats correlated with the prevalence of monieziasis (p<0.05). The goat\'s age category was also associated with the prevalence of strongyloidiasis (p<0.05).
UNASSIGNED: All the goats (100%) were infected with GiNCPs. The location (administrative cell) of the goat also correlated with the prevalence of monieziasis. In addition, the goat\'s age category was associated with the prevalence of strongyloidiasis. These findings show that any control program for caprine gastrointestinal parasitoses in the study area should focus on STNs and Coccidia.