European Journal of Molecular & Clinical Medicine

Introduction: Pterygium is one of the very common ophthalmic disorders with an unknown etiology and pathogenesis. Growth of pterygium into the cornea can result in visual impairment, astigmatism, loss of corneal transparency, visual axis obstruction.
Materials and methods: This cross sectional study was done on 500 patients, where demographic details was taken from all the patients including living environment, status, time outdoors, familial history, drug abuse, history of smoking, type of work and education, use of glasses. All of them underwent regular ophthalmic examinations including systemic and comprehensive examination as well as refraction.
Results: The prevalence of Pterygium was 12.6%. 35.6% of the patients were females and 64.4% were males. 51.2% belonged to the 30-39 year age group. 33.3% were farmers and 54% were manual labourers, 61.9%) of the patients had passed their high school while 28.6% were illiterate, 73% had no familial history of pterygium, 61.9% were regular smokers and 25.4% were occasional smokers. 36.5% of the patients had hypertension and 25.4% were obese.
Conclusion: Pterygium formation in our geographical area is quite high and the most common risk factor is exposure to sunlight. Male gender, hypertension and smoking also appear to be associated risk factors. Use of sunglasses may help in reduction of the prevalence of Pterygium.

Background & Method: The Study was carried out among UTI patients in Index Medical College and Associated Hospital at Khudel Village in Indore that gives healthcare to surrounding area and is used as teaching and referral hospital. The study targeted both male and female outpatients and inpatients presenting with symptoms and signs of UTI which include dysuria, polyuria, fever, nausea, and flank pain were sampled for this study. Baseline demographic data including age, sex, level of education and risk factors such as catheterization, history of UTI, also out and in patients were also collected.
Result: The 385 urine specimens processed, 112(29.0 %) showed significant growth whereas the majority of the urine samples that is 273 (71 %) showed no growth. Fresh samples were collected from patients by mid-stream catch method in sterile universal bottles (Plate 1). The assessment of associated risk factors showed gender (χ2 = 0.116, P=0.0412), age group (P=0.0120), History of UTI (χ2 =0.555, P=0.004) and symptoms of UTI (χ2 =0.895, P=0.017) were significant. Level of education (χ2 =2.742, P=0.523) and catheterization (χ2 =0.17, P=0.054) were not significant.
Conclusion: The prevalence of UTI in Index Hospital was 29.1 %. E. coli was the highest among 120 the isolates. Females had a higher (62.1 %) prevalence of UTI than males (37.9 %). Urinary tract infection was associated with the previous infection and with patients who had the history of catheterization. All isolates were sensitive to nitrofuratoin, cefotaxime and amoxicillinclavulinic acid. High resistance was observed in gentamicin, nalidixic acid, ampicillin and cotrimoxazole. In the 120 isolates were resistant for more than two antibiotics were recorded in 108 (90 %) isolates. Antibiotic susceptibility patterns of all patients with bacterial uropathogens will reduce multidrug resistance.

Background: One of the most common reasons to visit OPD in subjects of age less than 5
years is fever. Very little attention is given to UTIs (urinary tract infections) as the cause of
fever compared to other infections getting more attention. Without evaluating UTIs
adequately, antibiotics are commonly given to children empirically. To minimize lifelong
morbidity and provide prompt treatment, identification of UTI in children with fever is vital.
Aims:The present study was conducted to assess the UTI prevalence in subjects of age under
5 years and to assess the validity of urine culture and urine analysis for diagnosing urinary
tract infection.

Background: In pregnancy, anemia is a common disorder and is associatedwith an increased risk ofmaternal, fetal, and neonatalmorbidity and mortality. The present study was conducted to determine the prevalence and risk factors of anemia among III Trimester pregnant women attending OBG department, Government medical college &general hospital, Nizamabad.
Methods: A hospital based cross sectional study was conducted on 392 III Trimester pregnant women attending antenatal care at Governmentmedicalcollege&general hospital, Nizamabad from October 2020 to March 2021. Data on socio-demographic and clinical characteristics of the study participants were collected using a questionnaire and medical records. The haemoglobin was measured using an automated cell counter method and those with hemoglobin level less than 11 g/dl were considered as anaemic.
Results: The overall prevalence of anemiain our study was found to be 192 (48.9%).The age of the patients ranged from 18 to 35 years. out of all anaemic pregnant women about 100 were mildly anemic, 82 were moderate anaemic &10 were severe anaemic. Iron folic acid supplementation, antenatal care visit were significantly associated with the prevalence of anemia.
Conclusion: There is a high prevalence of anemiain III trimester pregnant woman attending tertiary care hospital in Nizamabad.Iron supplementation and health education to create awareness about the importance of antenatal care are recommended to reduce anemia.

Background: Spinal dysraphism is common congenital cause of disability in children
encountered by pediatric neurosurgeon and is a significant public health problem. Open
type spina bifida is more common than closed one. Though most of these cases are
diagnosed at birth or at an early infancy, some may be discovered in older children or
in adults. Aim & Objective: Our aim is to study the incidence, clinical presentations,
and surgical outcome in spinal dysraphism patients. Clinically patients are assessed on
the basis of history, presenting symptoms and neurological examination.
Results: A total of 54 patients included in this study. The age ranged from 1day to 17
years. The incidence is high in females 57.40 % (n=31) than males 42.60 % (n=23). The
swelling over the middle of the back was most common manifestation present in
32(59.2%) cases out of total 54 cases. 8 patients (14.81%) had ruptured
myelomenigocele/ myelocele sac. The skin markers which occur in spina bifida occult
type like dermal sinus, Hypertrichosis, dimple of skin present in 3(5.55%), 2(3.70%),
1(1.85%) respectively. Craniospinal MRI was done in all patients for evaluation of
congenital anomalies associated with spinal dysraphism. All were having one or
multiple anomalies. Spina bifida aperta (37) was more common than bifida occulta
which is noted in17 patients. Most common finding is myelomeningocele in 33 (61.11%)
cases, myelocele 4 (7.47%). In closed type, lipomyelomeningocele 7(12.96%) was most
common finding, and meningocele 3(5.55%), lipomyelocele 2(3.70%), diastematomyelia
in 2((3.70%), dermal sinus 2(3.70%), spinal lipoma in one (1.85%) case.Most of the
patients associated with hydrocephalus require shunt surgery prior to the definitive
surgery.The post operative care is equally important to avoid complications and for
better outcome. Electro myographic studies and urodynamic studies are required to
assess the sphincteric outcome following surgery. Pain is common symptom to improve.
Motor deficits improve better than sensory deficits and bladder dysfunctions post
operatively.Outcome of these patients are always at risk of retethering and delayed
neurological deterioration.
Conclusion: Therefore, close monitoring by a multidisciplinary team is important.
Inadequate treatment at peripheral centres should be avoided. Spinal dysraphism
patients should be referred to higher tertiary centre where the complete team is
available.

Introduction: Pleural effusion is common in medical ICU (MICU) patientsand may
affect patient outcomes.
Objective:This study aimed to determine the prevalence, causes, and clinical
significance of pleural effusion in critically ill patients.
Methods: A total of 500 patients included in the present study. The patients initially
had pleural effusion or effusion developed during their ICU stay.
Results: Overall, 350 patients were males and 150 were females, and their mean age was
51.5±18.6 years. Pleural effusion was found to be exudates in 60% of cases and
transudates in 40%. Uncomplicated parapneumonic effusion was the most common
cause (18%), followed by heart failure (16%). The cause of pleural effusion did not
significantly affect the patient outcome or duration of ICU stay. No significant
reduction in duration of ICU stays or ICU mortality was seen in patients who received
therapeutic aspiration or tube drainage compared with patients who received no
specific management for effusion.
Conclusion: The commonest cause of pleural effusion in MICU is parapneumonic
effusion, and chest ultrasonography is the best method of fluid detection. Different
methods of management do not significantly affect patient outcomes.

Background: Cholangiocarcinoma, including intra-and extrahepatic cholangiocarcinoma,
is a rare but highly lethal cancer. Despite effort in finding the risk factors of
cholangiocarcinoma, the causes of most cholangiocarcinoma remain unknown.There are
considerable geographic and demographic variations in the incidence of
cholangiocarcinoma. Although it comprises only 10-15% of hepatobiliary neoplasms, its
incidence is increasing. There are several established risk factors for CC and few are
modifiable which will help in reducing the incidence.
Aims and Objectives: To study the Prevalence and risk factors of cholangiocarcinoma at
GMC Budaun.
Material and Methods: All types of cholangiocarcinoma cases above age of 40 years
admitted to Department of Surgery, GMC Budaun U.P., were studied for risk factors over a
period of two years.
Results: An incidence of cholangiocarcinoma was 0.032% in present study. Peak incidence
of cholangiocarcinoma was 4th to 6th decade of life with mean age of 61.92 years. out of
26 patients 13 patients (50%) were smoker and in those 13 patients 12 (92%) were smoking
for more than 10 years and 13 patients (100%) were smoking more than 10 cigarettes or
bidi per day. 18 patients were using chulha (69%) for cooking meals with coal as a primary
fuel.
Conclusion: In conclusion, we found associations with PSC, smoking and alcohol
consumption; however, further studies are needed to establish the risk factors in our
country Long term exposure to pesticides in patients, who are chronic smoker and exposed
to smoke from chulha are at higher risk of developing CCA than others in this socioeconomic
scenario.

: Overall health status of an individual is greatly influenced by the oral cavity. Periodontal disease (PDD) and dental caries are the biggest threats to oral health among the various oral diseases. Despite increasing awareness and improvement in oral health, the global epidemiological data suggests that a worldwide prevalence of periodontal disease is 11.2%. It is a complex chronic disease which can lead to chronic inflammation, destruction of tooth supporting structures, and tooth loss in adults. With this background the study was planned to determine the prevalence of periodontal disease and perceptions towards oral health among the community in Aurangabad district of Maharashtra. Methods: A community based cross-sectional study was conducted among 2151 subjects in Aurangabad district, being the capital of Marathwada region by Rural Health Training Center, Paithan under Govt. Medical College, Aurangabad. The standard pro-forma was designed and house to house survey was conducted over a period of 3 months i.e. from June to August 2021. Mouth mirrors, caries explorers and periodontal probes were used for oral examination with proper aseptic precautions. All the findings were recorded in the data sheet and descriptive statistics and chi-square test were applied using SPSS-17 version. Results: Prevalence of periodontal disease in the present study was found to be 31.06%. It was observed that various factors act as predicators for periodontal disease. Conclusion: For reducing the disease Burdon and its impact on the community, school and community based oral health awareness programs should be implemented.

: A pleasant smile not only increases the face value but is also important for improving the quality of life of a person in a variety of spheres. Facial appearance has a long lasting implication on an individual. An unacceptable dental appearance has often been associated with a negative effect on self-image, career advancement and peer-group acceptance. The third most frequent oral disorders, alongside tooth decay and periodontal disease, are dental malocclusions. To confer a treatment plan and to work out on the treatment needs of a community group, it is obligatory to know the trends of occurrence of various malocclusions. With this background the study was planned to determine the prevalence and various preventive and treatment procedures of malocclusion in Aurangabad district of Maharashtra. Methods: A community based cross-sectional study was conducted among 2151 subjects in Aurangabad district, being the capital of Marathwada region by Rural Health Training Center, Paithan under Govt. Medical College, Aurangabad. The standard pro-forma was designed and house to house survey was conducted over a period of 3 months i.e. from June to August 2021. Mouth mirrors, caries explorers and periodontal probes were used for oral examination with proper aseptic precautions. All the findings were recorded in the data sheet after thorough examination. Descriptive statistics and chi-square test were applied using SPSS-17 version. Results: In the present study, prevalence of malocclusion was found to be 28.4%. Epidemiological studies on malocclusion not only help in orthodontic treatment needs and evaluation of dental health services but also offer a valid research tool for assessing distinct environmental and genetic factors in the aetiology of malocclusion. Conclusion: Drastic efforts are being taken by developing countries like India to eradicate many medical and dental diseases. Extensive multi centric studies are required to obtain a countrywide representative data.

Shoulder disorders are the most common complaint in general population and have an unfavorable outcome in many patients. Shoulder pain is the third most common cause of musculoskeletal consultation in primary care. Degenerative rotator cuff tear is the characteristic cause of shoulder pain and most often involves the supraspinatus tendon (SSP tendon). These tears can cause the significant impact on patient’s life, marking the functional impairment of shoulder joints. Plain radiography, ultrasonography, MRI, are the imaging modalities used for the assessment of rotator cuff-related pathologies. Ultrasonography of shoulder is accepted as the investigation of choice for rotator cuff abnormality mainly because it is non-invasive, cost effective, time consuming and well tolerated imaging modality that uses high frequency transducers to diagnose rotator cuff tears.This research deals with the study of prevalence of asymptomatic rotator cuff tears and their correlation with respect to age, sex, hand dominance and diabetes mellitus.

Background and Aim: Post operative bleeding is very common post operative complication seen in extraction cases. Anti coagulant therapies are employed to manage several clinical conditions. Patients those who are already on anti coagulant therapy, can show different patterns of post extraction hemorrhage. Anti coagulant makes blood flow via veins more easily. So, blood will be less likely to make a dangerous blood clot (like thrombosis or embolism). The sole endeavor of present study was to evaluate the correlation of post extraction hemorrhage and anti coagulant therapies in younger population. This study was retrospectively performed to assess the related prevalence also in the studied population. Materials & Methods: Patients case history, follow up case sheet and discharge summaries were explored. Younger age group patients those had undergone single tooth atraumatic extraction for different reasons, were selected for study. Patients who reported to be on anticoagulant therapy for more than one year, were studied in group one. Patients who reported to be on anticoagulant therapy for six to twelve months, were segregated in group two. Patients who reported to be on anticoagulant therapy for less than six months, were studied in group three. Patients not receiving this therapy were served as control group or group four. Post operative bleeding was studied under five categories in each group. These were mild, moderate, severe, uncategorized and no bleeding. Statistical Analysis and Results: Statistical analysis was done by statistical software Statistical Package for the Social Sciences (SPSS). P ≤ 0.05 was considered as statistically significant. Total 84 male and 36 female patients were studied in this study. Therefore, majority of the studied patients were male. In group I, 9 out of 30 patients had no bleeding. However, 8 patients showed severe post operative bleeding. 5 patients showed only mild bleeding. In this group (group I), P value was significant for all five severities of bleeding. In group IV, 23 patients had no post operative bleeding. Nevertheless, only 1 patient showed severe post operative bleeding. Only 1 patient showed mild bleeding. In this group (group IV), P value was significant for patients with no post operative bleeding (0.03). Conclusion: Within the limitations of the study, authors concluded that anti coagulant therapies are significantly affecting post operative bleeding in extraction cases. The relative severity and prevalence of bleeding are also exaggerated by time period of anti coagulant therapy. Patients those who were on anti coagulant therapy for more than one year, showed maximum prevalence and severity of bleeding.

This study was conducted to estimate the prevalence and distinguish kinds and related factors
of Mental Disorders among elderly people attending Geriatric Clinic, Baghdad, Iraq.
Methodology: A cross-sectional study conducted and a systematic random sampling technique
was used to select 320 elderly people. We collected data on basic demographics and associated
risk factors using a questionnaire filled through self-reported questionnaire. Mental disorders
(MDs) were defined according to Kessler Psychological Distress Scale (K10) with a cutoff score
of 20+. Accredited tools used by WHO were utilized to identify mental disorders kinds. Results:
The prevalence of MDs in the study sample was 24.4%. The prevalence of MDs types were:
Depression 16.6%, anxiety 12.8%, dementia 5.3%, substance abuse 2.5%, suicide thoughts
5.6%, and suicide attempts 2.5%. Logistic regression analysis was used to examine the
determinant factors of elderly MDs revealed the following significant factors: Aging, smokers,
living depends on others, loneliness and social isolation, visual impairment, economic state
deterioration, neglect and mishandling, and chronic diseases are the determinant factors of
elderly MDs. Conclusions: Mental disorders are wide spread among elderly people and
enhanced elderly mental health care services should be provided

OBJECTIVE: To study the prevalence and association of psychosocial concomitants with
dental fear and anxiety (DFA) in children aged 3-18 years in Lucknow, Uttar Pradesh.
STUDY DESIGN: This observational study was conducted among children aged 3-18years
who visited the Department of Pedodontics and Preventive Dentistry at Babu Banarasi Das
College of Dental Sciences, Lucknow. A clearance for the study was obtained by the
Institutional Research Committee. DFA levels for prevalence were assessed using Children
Fear Survey Schedule-Dental Subscale (CFSS-DS). Psychosocial concomitants were recorded
with the help of semi structured designed questionnaires separately for patients and parents by
the psychologist. It dealt with socioeconomic factors, family situation, medical and
psychosocial history, child’s daily life, adjustments and interactions. Parent’s questionnaire
included the reason for visit, awareness about milk teeth, brushing schedule, family living
style (nuclear or joint, number of children, education and occupation of parents). Obtained
answers from the questionnaire were graded using the semantic scale and some with the
dichotomized answers (yes or no).

To determine the prevalence of refractive errors among the type 2 diabetic population through a community-based study conducted in Lucknow.
Background of the study: Diabetes prevalence is on the increase rapidly the epidemic proportions during development as well as the world developed. Refractive error in the diabetic population is considered a leading cause of visual impairment.
Methods: A total of 437 patients (> 40 years old) with type 2 diabetes were examined via complete eye screening tests, including objective autorefraction. Spherical equivalent refractions of both eyes were reported. Data collected include age, gender, general medical information, and serum biochemistry.
Results: The mean refraction was −0.84 ± 2.59 D. Prevalence rates were determined for astigmatism (63.8%), hyperopia (1.4%) & myopia (0.2%). 34.6% of the patients were emmetropic. Age is an essential factor for all refractive errors. Correlation showed that every increase of one year of age and one percent of HbA1c is associated with 0.05 D (P = 0.003) and 0.14D (P = 0.04) shift in hyperopia, respectively.
Conclusions: This study provides epidemiological data on refractive errors in a North Indian diabetic population in Lucknow, India. The astigmatism prevalence is higher than the reported rates in the diabetic population compared to hyperopia and myopia. The second major finding was emmetropia.Refractive errors, Type 2 diabetes, Prevalence, Community-based stud

Introduction:The neonatal period comprising the first 4 weeks (28 days) of a child's life after birth is critical and dangerous events might occur. Structural, functional changes occur rapidly in this period. It is very important for mothers to be aware of the danger signs in neonates during this period. This study was done to find the prevalence of knowledge and awareness of danger signs among mothers of children aged less than 1 year.
Methods: A Community based cross-sectional study was carried out in United Arab Emirates from June 2020 to August 2020. Simple random sampling method was used and the sample size was calculated as 150. Mothers of children aged below 1 year were included in the study. A semi-structured pre-tested questionnaire was used in this study for interview purposes. Informed oral consent in common languages- English, Hindi, Tamil, Telugu, and Malayalam was obtained.
Results: The prevalence of good knowledge of danger signs among mothers of children aged less than 1 year in this study was found out to be 28.6%. 91.2% of the mothers have reported having sought medical care when any of the mentioned Danger signs occurred whereas 8.7% of them had opted to treat at home.
Conclusion:In spite of extensive coverage of maternal and child health services, the knowledge and awareness of the danger signs in neonates are fairly low in the mothers. Therefore more awareness and health education campaigns need to be implemented.

Background of study: Soft tissue injuries include pain, weakness, numbness, and tingling sensations involving the muscles, ligaments and tendons. The etiological factors of these injuries can be professional, personal, environmental, and psychosocial. These disorders in musicians are designated as playing related soft tissue injuries. Aim of Study: To investigate the disability and severity of playing related soft tissue injuries among professional guitar players. Methodology The cross sectional survey was conducted from February 2017 to June 2018 after taking ethical approval from institutional ethical committee. The participants fulfilling the inclusion criteria were recruited through convenient sampling technique and informed consent was taken. A structured anonymous questionnaire and validated scales like Disability Arm Shoulder and Hand Scale (DASH), Neck Disability Index (NDI), Oswestry Disability Index (ODI) Oswestry Disability Index (ODI) were used for data collection. The results was assessed by using IBM SPSS Version 20.0. Results: In this study 98 participants were included constituting 50 (51 %) females and 48 (49 %) males. The highest prevalence site of pain was wrist 57% followed by back 26 %, shoulder 22 % and elbow 21 % while least pain was reported in neck 7 %. Likewise, When Compared with DASH score was more than to ODI and NDI score was lower with significant difference assessed at 95% confidence interval (p < 0.05) Conclusion: This study concludes severity of soft tissue injuries are more prone in guitar players. The common sites was in wrist, shoulder, back. Proper technique, postural education, warm up and cool down will benefit in reducing the risk of injuries.

The aim was to study the prevalence and risk factors of dental disease development in
pregnant women living in different Uzbekistan regions. The prevalence and intensity of dental
caries among pregnant women are 1.3 times higher in the Urgenchdistrict of the Khorezm
region compared to the Kibray district of the Tashkent region. These figures increase with
each subsequent pregnancy. The same pattern is observed for periodontal and oral mucosa
diseases. The most significant medical and biological factors contributing to the development
of dental diseases in pregnant women were age, several pregnancies, intergenerational period,
course and terms of pregnancy, the presence of extragenital diseases. Among medical and
social risk factors, the most significant were education, living conditions, oral hygiene,
sanitary culture, and medical activity of pregnant women.

The aim of this study was to assess the prevalence of missing permanent first molars in the South Indian population who reported for orthodontic treatment to a dental hospital. A total of 550 OPGs of patients who reported for orthodontic treatment to the hospital were assessed for missing permanent first molars.The data was retrieved from the extensive electronic database record of the hospital. Descriptive analysis was done to represent the data. Prevalence of missing permanent first molars was found to be 5.8%. A significant percentage of the orthodontic population have missing permanent first molars. A thorough clinical examination, from an orthodontic perspective will help formulate a better treatment plan.

patients who underwent frenectomy/ frenotomy for high frenal attachment in a dental hospital from June 2019 to March 2020. No gender or age restrictions were. 99 patients were included in the study. Digital case sheets were reviewed and the following data including the details like patients gender, age, site of high frenal attachment, reason for frenectomy were extracted, tabulated and analysed statistically with Chi square test using SPSS version 20. Among those 99 frenectomy cases. The males were ( 43.4%) and females were (56.6%). The prevalence of frenectomy was more in female gender as compared to male gender. The common reason behind frenectomy was spacing (61.6%) and the more common site of high frenal attachment was S2 (Maxillary anterior sextant) (55.5%) compared to S5 (Mandibular anterior sextant). There was a significant difference in the reasons for frenectomy between site(p < 0.05 )and sites underwent frenectomy and age of the patient(p < 0.05).No significant difference in the reasons for frenectomy between males and females (p > 0.05). From the study it can be concluded that the common reason for frenectomy is diastema and the reasons for frenectomy is influenced by the site of high frenal attachment and the age of the patients.

Dental caries(DC) is one of the most prevalent oral diseases of health concern often affecting adolescents.Dental caries is a biofilm mediated,diet modulated, multifactorial, non communicable,dynamic disease resulting in net mineral loss of hard fissure of the oral cavity. It is determined by biological, physiological, behavioural and environmental factors of an individual. As a consequence a carious lesion is produced. People of all ages are affected by dental caries.Adolescents are individuals between 10-19 years old and proven to have a high caries experience. The aim of this study is to evaluate the incidence of Dental caries among 10-19 years old patients visiting Saveetha Dental college between june 2019-april 2020. A total of 5445 patients data was analysed from their case records and analysed for incidence among gender,correlation with age.It was found that out of 5445 patients,3021 patients(73%) were male and 2412 patients(25%) were female and 2 patients(2%) were transgenders.Patients of the age group of 13-19 years had more incidence and the age group of 14-15 year old had least incidence. Within the limitations of this study it can be concluded that male patients have more DC than female patients among the 10-19 years age group in an outpatient population of a Dental College.

Introduction:
The permanent first molar teeth are the most caries prone teeth in mixed dentition. Reasons for permanent molar teeth loss include poor prognosis, caries,orthodontic and periodontal reasons. This study was done with the aim to assess the common reasons for extraction of first permanent molars in children between 6-17 years of age.
Materials and methods:
A total of 89000 case sheets were reviewed and cross verified from June 2019 to March 2020. Data related to permanent molar extractions were retrieved by searching with Patient ID, age, gender ,tooth number and treatment relevant to the study. Data was tabulated in the excel sheet. Statistical analysis was done using Statistical Package for the Social Sciences software(version 9.0.3). Results were statistically analysed using association analysis.
Results:
Higher number of males (64.47%) had first permanent molar extractions when compared to females (35.53%). In males, dental caries with pulpitis (22.37%) was the most common reason for extraction of permanent molars. In females, root stumps(13.16%) was the most common reason for extraction of permanent molars. In both 8-12 years age group and 13-17 years age group, dental caries with pulpitis (34.21%) was the most common reason for extraction of permanent molars.
Conclusion:
Within the limitations of the current study, first permanent molars were commonly extracted among males and dental caries with pulpitis was the most common reason for extraction of first permanent molars.

It has been established that smoking is a very different addiction to break. Many smokers persist in
tobacco use for several years and cycle through multiple periods of remission and relapse Smoking is not a
single event process and relapse is an ordinary component of this process. International guidelines have
greatly emphasized on relapse prevention. Very few studies examine the association between the number
of cigarettes smokers consume per month and their response to cues derived from peer and physiological
distress. This study aims to evaluate association between peer pressure and relapses during tobacco quit. A
retrospective study was conducted by reviewing 75,000 patient records of University hospital for a period
of nine months from June 2019 to March 2020. About 150 case reports containing information on tobacco
dependence and quit rate (in terms of number of relapses) were retrieved and analysed. Descriptive
statistics was done to present the sociodemographic details. Chi-square association was done to find the
association. Most of the participants (34%) were in the age group 29-38 years, followed by 49-59 years
(26%), 19-28 years (24%) and 39-49 years (16%). About 13.3%, 20%, 4%, 10% of 19-28 yrs, 29-38 yrs,
39-48 yrs and 49-59 yrs of patients respectively had peer pressure during their quitting process.About
11.3% 20%, 8.67 and 13.3% of patients in the age group 19-28 yrs, 29-38 yrs, 39-48 yrs and 49-59 yrs had
no relapses during the quitting process.No significant association between age and number of relapses
(p=0.746; not significant). Hence proving no influence of age on relapse during quitting process. About
28% of patients with peer pressure and 25.3% without peer pressure had no relapse during quitting.
However 19.3% and 27.3% with and without peer pressure had >1 number of relapses. during their
quitting process,No significant association of peer pressure in relapse (p=0.295, not significant). No
influence of peer pressure on relapse during the quitting process. Peer pressure is not much influencing the
number of relapses during the quitting process, however a watch over this factor to be taken in account
during cessation counselling

Dental injuries result in functional , esthetic and psychological disturbance accompanied by great concern.Traumatic dental injuries are due to the physical impact on a tooth and its surrounding tissues which may be direct or indirect trauma to the teeth may result either injury of pulp, with or without damage of crown or root displacement of the tooth from the socket. The most frequent causes of these injuries are falls, sport activities, bicycling, traffic accidents. A cross sectional retrospective study of, study population will 100 adult patients visiting Saveetha Dental College and Hospital with tooth fracture . Data was gathered and analyzed. The data was tabulated and Chi square analysis done using IBM SPSS software version 20. With the limited population and parameters of this study, there is a more prevalence of tooth fracture in male over females .The most common tooth involved in fracture is 21.Traumatic dental injuries are recognized as a public dental health problem worldwide.

Background: at a global level and among child bearing age women, the first leading disease burden cause is the depression. Nationally, scarce published data was related to the depression prevalence among pregnant especially with hyperemesis gravidarum women. Aim: to assess the depression extent among hyperemesis gravidarum pregnant Thi-Qarnian women. Methodology: A cross sectional, hospital based, analytical study was carried out in two teaching hospitals (Bent Al Huda and Al Habobi teaching hospitals) in from first week of September /2015 to end of July 2016. All attendants sufferer pregnant from HG to the obstetric outpatients included in this study. Based on previous Iraqi study (37.2%) for of depressive symptoms prevalence in pregnant women sample size had been calculated such prevalence rate with precision of 5%, confidence level of 95%, and added extra sample of 10%, to reach to 322. Beck depression inventory-II (Arabic version) (BDI –II score of > 20 depression was considered) had been used as a specialized questionnaire designed for the achieve the aim of the study. SPSS version 23 had been used for data analysis, P

Orofacial infections of odontogenic origin have long plagued mankind. The discovery of the miracle drug
by fleming in the year 1928 and the routine use of penicillin after the landmark discovery of the powder
form of the antibiotic by florey and chain leading to significant change in the management of odontogenic
infection .The spread of infection is governed by factors such as impaired host defence, the virulence of
microorganism, functional abnormalities of the host and a lack of or delayed treatment. the microbiology
of odontogenic infections in diabetic and non-diabetic individuals has been found to be variable. Though
the effects of diabetes can affect infection severity , length of hospital stay, susceptibility to antibiotics
and outcome of treatment is unassured . Differentiation in antibiotics prescribed is also observed.The aim
of the study was to analyse the prevalence of the use of antibiotics among diabetic and non-diabetic
patients in a south indian dental university clinic . The list of all diabetics and non diabetics patients
treated for pain, dental infections , swelling were retrieved by reviewing 86000 patient records who have
visited the hospital during the study periods from june 2019 to march 2020 from the university
database.Data tabulation was carried out in Excel. The data was imported and transcribed in Statistical
Package for Social sciences version 16(SPSS,IBM corporation). Descriptive analysis was carried out.A
total of 9128 patients were included in the study based on treatment done of which 580 patients(6.3%) had
diabetes mellitus. Only 3.5 % of the male population and 2.8% of the female population has
diabetes.Amoxicillin 93.2% was found to be the most frequently prescribed antibiotics among nondiabetic
patients and diabetics patients 1.6% .A combination of metronidazole and amoxicillin was
prescribed to 0.5% of the whole study population .A combination clavulanic acid and
amoxicillin(augmentin )was prescribed to 4 % of the total diabetic study population and 0.4% of the nondiabetic
study population that is about.The relation between the diabetic status of a patient and the
antibiotic prescribed showed a significant statistical relationship in a Pearson's Chi square test with p value
of 0.001(p<0.005).The prescribing practises in dental offices can be improved by increasing awareness
among dental practitioners about the recommended guidelines for prescribing antibiotics . The most
commonly prescribed antibiotics among diabetic patients was Augmentin (4.08%) and for non diabetics it
was amoxicillin (93.25%). .

Dental erosion is a public health problem as it may affect various age groups and gender. It may lead to dentin hypersensitivity and eventually pulpal exposure if the erosion is severe and not treated which causes pain. Therefore, the study was done to find the association of gender with dental erosion. A retrospective study was conducted using University hospital patient records from July 2019 - March 2020. A total of 149 case sheets were reviewed. The data variables such as socio-demographic data, presence of dental erosion and number of teeth involved with dental erosion were retrieved and analyzed. Results were present with frequency distribution and chi-square test for association. Dental erosion was prevalent in males (64.4%) than females (35.6%). The age range of the patients included in the study was 21-80 years old out of which 21-40 years (14.8%), 41-60 years (57%) and 61-80 years (28.2%). Erosion in maxillary teeth involving 0-5 (85.8%) was the highest followed by 6-10 (14.1%) and erosion in mandibular teeth involving 0-5 (87.9%) was the highest followed by 6-10 (11.4%) and 11-15 (0.7%). There was no statistically significant association between gender, age with dental erosion in maxillary and mandibular teeth (p>0.05). Within the limitations of the study, it can be concluded that dental erosion was prevalent in males of early 60’s and there was no association between gender, age with dental erosion in maxillary and mandibular teeth.

Rubber dam was introduced by Dr.Barnum in the 1860 s, the main advantage of using rubber dams in endodontics include patient protection from medicaments, aspiration of endodontic instruments, tooth debris, and irrigating solutions. The aim of the study to determine the prevalence and frequency of rubber dam usage during endodontic procedures among dentists in the state of TamilNadu, India.A survey was conducted among 101 dentists in the state of Tamil Nadu, India by preparing a set of questions, and the answers were collected through an online survey method.In this survey, 82.2% feel comfortable to use a rubber dam,36.6% never use a rubber dam to pediatric patients,89% always use a rubber dam to adult patients,61.4% not using rubber dam for all cases of RCT,73.8% need to gain knowledge about rubber dams through training programs,23.8 % told patients discomfort was a reason for not using a rubber dam, 80.2% not using rubber dam while taking X- rays,45.5% take more than 5 mins for applying a rubber dam to patients,63.4% told it is easily available for clinical usage.The present survey shows there is a low prevalence of its usage during endodontic treatment. Greater emphasis should be placed on the advantages of using rubber dams in clinical dentistry at dental school and through continuing dental education for practitioners to update their knowledge

Pregnancy has some physiological changes which complicate the process of diagnosis and treatment. Over 200 million people suffer from anaemia especially among women of reproductive age. Anaemia is a major health problem among pregnant and non-pregnant women. Anaemia during pregnancy is considered as a public health problem especially in developing countries. The World Health Organization (WHO) defined anaemia during pregnancy as a haemoglobin concentration of less than 11g/dl. In severe anaemia, the haemoglobin level is 6g/dl. Anaemia threatens both mother and foetus. The causes may be multifactorial, such as nutrient deficiency, parasitic infections or chronic infections. It may also be due to acute blood loss. It may also depend on geographical location and economic status. The effects of anaemia on mothers are tiredness, weakness, dizziness and affects the immune system. In children, it may cause preterm delivery, low birth weight. On both the mother and the fetus it can cause mortality and morbidity. Intake of balanced diet and awareness programmes on anaemia is a measure to prevent anaemia. This study is to evaluate the awareness and prevalence of anaemia among pregnant women. A cross-sectional survey was conducted containing a set of self-developed questionnaires. The data was collected and analysed using SPSS software. The results are analysed and tabulated. The result was gained as follows, 25% of the participated population‟s haemoglobin level is less than 11, 75.89% of the population participated are aware that anaemia can affect pregnant women, 66.07% of the population agree that haemoglobin level less than 11 can cause anaemia. From the study, it is obvious that there is an awareness between the effects of anaemia during pregnancy.

Background:Asthma, the most common chronic illness in children is responsible for more school absenteeism than any other single chronic childhood condition. Acute asthma attacks while at school can cause considerable disruption to scheduled school activities, broadening its impact on school participation. Children with asthma face multiple challenges that encompass learning how to cope with. Bronchial asthma (BA) is a public health problem in all countries irrespective of their level of development, being generally under-diagnosed and undertreated, and most asthma-related death commonly occurs in low-income and lower-middle income countries. As for Saudi Arabia, it is estimated that more than 2 million Saudis have asthma, and the percentages range from 8% to 25% in Saudi children. In 2004, the highest prevalence of asthma was reported by physicians in Saudi Arabia (25%). Bronchial asthma is a serious disease since it is very common disease in Saudi Arabia, and it doesn’t only affect the individual physiologically, however it also affects the individual’s quality of life, leading to missing days from school or work, emergency hospital visits, hospitalization, and caregivers and parents’ time and effort. Consecutively, it affects the whole community.
Aim of the study:To assessment the knowledge of the regarding childhood asthma at Makah city in Saudi Arabia. 2019.
Method:A cross-sectional study was conducted   attending the primary health care centers in Makkah, Saudi Arabia. An asthma knowledge questionnaire was used to measure the knowledge. during the April to June, 2019, participants were (800).
Results: Regarding awareness of the participant toward asthma study results show the majority of participant had average information were(59.0%) while weak awareness were(22.0%) the data ranged from(6-28) by mean ±SD(16.577±5.87).
Conclusion:The bronchial asthma knowledge in the Saudi Arabian population is insufficient, and efforts should be carried out to spread asthma knowledge to the people. Bronchial asthma management should include patients, parents, and public awareness regarding the disease, its symptoms, medications.

Background
Antibiotics are the most commonly used drug group in hospitalized patients and primary health clinics as they are all over the world. Inappropriate or unnecessary use of antibiotics leads to adverse effects related with antibiotics, occurrence of resistant microorganisms, and increased therapeutic cost. With the Budgeting Application Instruction, which entered into force in 2003 for controlling antibiotic use, approval of an infectious disease specialist (IDS) was required for use of some differences in antibiotic knowledge and attitudes between parents of Medicaid-insured. It is unknown whether understanding has improved and whether previously identified differences persist.Efforts to reduce antibiotic misuse and overuse are necessary to curb additional increases in antibiotic resistance in developed and developing countries also in KSA saw increases in antibiotic use for children during the last 2 decades, no educational campaigns for patients and professionals, and introduction of new vaccines. ​
Aim of the study: To assessment of prevalence of antibiotic use for pediatric acute viral gastroenteritis attending the primary health clinics in Makah city in Saudi Arabia 2019.
Method: This is a cross-sectional study, thirty questions of children years of age who had suffered from acute gastroenteritis during the March to June, 2019 was conducted attending the primary health care centers in Makkah, Saudi Arabia. our total participants were (80).
Results:Oral antibiotics were preferred by 45.0% followed by intravenous route (30.0%), and intramuscular route in 8.75%. Antibiotics less than week were prescribed in about 43.0%. Duration from 7-14 days was recorded by 20%. Long-term antibiotics were prescribed by 3.0%. Questioning about the seasonal break out of viral gastroenteritis as stated by study individuals.
Conclusion: must be Antibiotic use based on consultation with an infectious diseases specialist decreased inappropriate antibiotic use. Acute gastroenteritis is a major source of morbidity and mortality among young children in developed and developing countries. Enter pathogenic viruses are regarded as particularly relevant causative agents.

Background:  Workplace violence (WPV) is a serious worldwide concern, especially for health care professionals when compared with workers in other industries. Violence in the health care sector harms both patients and health care professionals and causes enormous economic losses. Victims of WPV show signs of anxiety, depression, and low efficiency in their work performance, which may decrease the quality of the service that they provide. Among health care professionals, nurses who have direct contact with patients face numerous risks related to WPV. Therefore, it is important to recognize risk factors that can be used to reduce the incidence of WPV against nurses. Emergency healthcare workers (HCWs) have a high risk of exposure to violence with negative personal consequences. Violence is an occupational hazard in hospitals. Occupational researches have gradually shifted focus from traditional, visible environmental risk factors, such as physical, chemical, biological exposure or ergonomic problems, to the invisible, psychological harm that maybe present in the workplace.
Aim of the study: To assessment of Prevalence  of Workplace Violence among  and Nurses and Physicians at Emergency Department in  Primary Health Care Centers and confirm the factors influencing such violence.
Method: Cross-sectional analytical study has been conducted at emergency departments (EDs), Primary Health Care Centers in
Makkah city, during data collection period 2019, the total sample has been (400) nurses and physicians.
Results: Regarding the age the highest age were (35.0%) were (30-40) years and the data ranged from (22-57) by mean ±SD (38.315±9.816), were females (57.0%)while males. The majority of the participated nurse were(67.0%), followed by doctor were(33.0%). Regarding the qualification, the majority of participated heave Bachelor were (28.0%) followed by Resident (21.0%), the participated experience in from 6-10 years were (31. 0%).More than half of the participants were yes to physical or verbal violence and their percentage was (75. 0%).Conclusion: Workplace violence was prevalent, and verbal abuse was the commonest type among HCWs in emergency departments of PHC.  Workplace violence, a possible cause of job stress, has recently become an important concern in occupational health. Almost half of the ED nurses and physicians experienced one or more WPV incident.

Background:
     Physical activity (PA) is defined as any bodily movement produced by the contraction of skeletal muscles that results in a substantial increase in caloric requirements over resting energy expenditure. According to the World Health Organization(WHO), physical inactivity is considered the fourth leading risk factor for global mortality. Physical inactivity is associated with excess weight and adverse health outcomes. In particular, office-based screening of activity levels and physical activity counseling coupled with regular follow-ups and community support and referrals for physical activity, have been proven effective in increasing physical activity levels. In addition, the cost of integrating physical activity counseling and referral schemes into primary health care teams has been found feasible and cost-effective Physical activity can be defined as any movement of the body that requires energy expenditure.
 
Aim of this study: To Assessment of the Prevalence of Physical Activity among Adult Patients attend primary health care centers in Makkah city, Saudi Arabia.
 
 Methodology: Cross sectional design has been adopted. The study has been conducted in Makkah city, Saudi Arabia. The present study was conducted at primary health care centres in Makkah city. Systematic random sampling was being adopted to select persons during the March to June, 2019.The sample (300).
 Results: Exercise milieu these study results showed that Positive Exercise milieu proportions (62.0%), and Negative Exercise milieu proportions (38.0% ) while  the Range  (8-22)  Mean +SD (13.254±3.215) while Time expenditure the most of them negative were(69.0%)but positive (31.0%)while the Range (6-13) Mean +SD (10.812±2.77)
 
Conclusion: Physical inactivity among Arab adults and children/adolescents is high. Studies using harmonized approaches, rigorous analytic techniques and a deeper examination of context are needed to design appropriate interventions. Physical activity likely has a greater role in promoting health in disease populations than previously thought and may confer substantial reductions in disease burden Primary health care centers in Makkah should be active and able to provide health advice and behaviour to their patients. There will a strong intention to increase physical activity among physically inactive primary care physicians (PHCPs).

. Background
Migraine poses a significant burden for patients, and it has multiple diagnostic and management challenges, particularly among primary health-care workers ( physicians, nurse, administrative). Migraine is a public health problem and it is the third most common cause of disability among individuals below the age of 50. In spite of the multiplicity of the studies concerned with exploring the disease epidemiology and nature worldwide, data from Saudi Arabia are lacking.  Migraine is one of the most critical concerns among healthcare providers and other relevant stakeholders in the health sector. It is one of the significant causes of disability among older patients (aged 50-years and above). Saudi Arabia has had its share of the health issue with the ever-increasing prevalence of migraine in the country. Despite the concerted and collaborative efforts among major stakeholders on the provision of the assessment of the identified health problem, data from Saudi Arabia mostly lack, especially on the epidemiology of the health condition. According to the recent reports from the Global Burden Disease (GBD), migraine ranks third among the leading cause of disability globally. The prevalence rate varies significantly within the Arabian countries; Saudi Arabia (12%), Qatar (72%), and Oman (83%).
 Aim of the study: To assessment the levels of knowledge of the prevalence  Migraine headache among healthcare providers in PHC centers in Makkah City, Saudi Arabia, 201
9 Method:Across-sectional study among healthcare providers who works in primary health care center in Makkah Al-Mukarramah 2019, the study has been conducted healthcare providers who works in PHC centers in Makkah city KSA. Was conducted using questionnaire designed during August 2019. The questionnaire collected the socio-demographic factors, a migraine screen questionnaire (MS-Q) Migraine Disability Assessment questionnaire (MIDAS), our total participants were (200)
Result:Conclusion:Knowledge regarding migraines diagnosis and treatment was inadequate among healthcare providers , which could detrimentally influence the patterns of referral to secondary health-care facilities, severity of symptoms was accompanied by poor quality of life in terms of social and professional aspects. There was a lack of awareness in majority of subjects about migraine leading to underdiagnosed, under treatment and with high use of over the counter medications. There is a need for proper awareness campaigns in Saudi population and also healthcare providers.

background: Most health care providers are aware of e-cigarettes, but the information is scarce regarding the magnitude of this newly emerged habit in Saudi Arabia, since introduction in the early 2000s, e-cigarette use has rapidly increased among adolescents worldwide. then adult  However, little is known about e-cigarette uptake among adolescents in Saudi Arabia. Tobacco smoking is highly prevalent in Saudi Arabia, and there is a need to reduce the resultant health burden via patient-oriented smoking cessation interventions. Primary care physicians (PCPs) have a significant role in providing counseling and advice to quit smoking.
World Health Organization (WHO) reported tobacco use as one of the biggest public health threats the world has ever faced. WHO report on the global tobacco epidemic, mentioned that in 2015, over one billion people smoked tobacco. This study aimed to assess Prevalence of Electronic Cigarettes Use Among health care providers in the Primary Health Care in Makkah, Although it is declining worldwide in many countries, the prevalence of tobacco smoking appears to be increasing in the Eastern Mediterranean Region
.Aim of the study
This study aimed to assess Prevalence of Electronic Cigarettes Use Among health care providers in the Primary Health Care in Makkah 2019.
methods:Cross-sectional descriptive study was carried out, including a random representative sample of health care providersin the Primary Health Care in Makkah.A self-administered validated questionnaire was adopted and modified. The Sample size of medical practitioners . Our total participants were (500)
Results: showed that the majority of the participant were (52.0%) smoker regarding smoking period the majority while <5 were (35.0%), Current use of e-cigarettes were(72.0%) and (30.0%) of the participant knew that the electronic cigarettes contain nicotine whereas 56.15% did not know if e-cigarettes contain nicotine or not. Most of the students (75.0%) thought that the electronic cigarette is harmful to health.
Conclusion:The prevalence of e-cigarettes smoking among health care providers in the Primary Health Care in Makkah. was found relatively high and most common reasons to smoke e-cigarettes were similar taste to conventional cigarettes, adequate nicotine, helping in control of smoking behavior, perceived less harmful effects than conventional cigarettes, and low cost. E-cigarettes have been tried and currently used by a considerable proportion of health care providers. Some associated factors were identified.

Background
Obesity is emerging as a serious problem throughout the world, not only among adults, but also health care worker and children, teenagers and young adults. Of the factors contributing to obesity, stress seems to be particularly important as stressful condition leads to irregularity in worker in work, lack of exercise and addiction also considered independent and factors leading to stress. Workers in the health care is stressful throughout the whole work time. The amount of material to be absorbed, social isolation, pressure of examination, discrepancies between expectation and reality all can be anticipated to bring psychological stress. Prevalence of Stress and its Association with Body Weight Among health care worker,
Prevalence of stress and its Association with Body Weight Among health care worker fears related to stress have affected a considerable number of health care worker, especially the nursing category,studies have shown that healthcare workers managing patients have been experiencing worse psychological issues such as stress than the public because they are more likely to get infected and transmit the infection to their relatives and friends.
Aim of the study: To assessment of the prevalence of stress and its association with Body Weight Among health care workerin Primary Health Care Centers in makkah 2019
Method:Cross-sectional analytical study has been conducted health care workers at Primary Health Care Centers in Makkah city, that included all health care worker during data collection period 2019 the perceived stress scale-10 questionnaire used to measure the stress score. Weight and height were collected based on self-reported value.  the total sample has been (400) nurses, physicians and other
Result:the majority of the respondents were married status were (75.0%) while other were (14.0%).  The association between the stress and stress score most of the participant moderate Stress were constitutes (47.75%) followed by low stress the were constitutes (44.75%) while a statistically significant (P-value =0.001) and Chi-square (120.665), the Range (5-45) (Mean ± SD (25.441±6.125).
 Conclusion:Stress is prevalent among health care worker at Primary Health Care Centers, Makkah we found a positive correlation between BMI and stress but no statistically significant association between gender and stress level. Preventive measures should be implanted to reduce the level of stress and interventional studies are needed among health care worker at Primary Health Care Centers.

Background: Lower urinary tract symptoms and urinary incontinence are very common in the general population and increase in prevalence in association with age. Urinary incontinence in particular is still seldom discussed by patients, many of whom delay seeking healthcare for the condition. Urinary symptoms have a considerable impact on morbidity and quality of life. Older people encounter multiple barriers in gaining treatment for their problem and are unfortunately less likely to be given evidence-based treatment than younger people. Urinary incontinence means a person leaks urine by accident. While it may happen to anyone, urinary incontinence is more common in older people, especially women. Incontinence can often be cured or controlled. The body stores urine in the bladder. During urination, muscles in the bladder tighten to move urine into a tube called the urethra. At the same time, the muscles around the urethra relax and let the urine pass out of the body. When the muscles in and around the bladder don’t work the way they should, urine can leak. Incontinence typically occurs if the muscles relax without warning.
Aim of the study: This study aims to assessment the prevalence of urinary incontinence among elderly patients attending the primary health care centers in Makkah Al-Mukarramah, KSA.
 Method: A cross-sectional study will be conducted to estimate the prevalence of self-reported UI among elderly patients attending primary health care centers in Makkah Al-Mukarramah in date collection period. Our total of simple is (400) elderly patients
Results : A total of is (400) elderly patients .The majority of the respondents were females (57.14% ), Malays (42.86 %), The age of the respondents ranged from 25-65 years, with a mean of 37.87±12.088 years showed positive correlations between degree of symptoms and signs of diagnosis of incontinence and degree the Frequency of symptoms Where (r = 0.578) and have statistical  a significant relation where p < 0.001).
 Conclusion:Urinary incontinence is common and often disturbing Saudi elderly, our study found that the prevalence was it adversely impaired their quality of life (QOL). Elderly age and parity were significantly related to impaired QOL. We acknowledge the fact that urinary incontinence is a common and poorly understood problem in our community.  Another problem in the elderly age group is cognitive impairment, which also contributes to urinary incontinence. Prevalence of urinary incontinence is most likely underestimated.

Background:
Psychiatric disorders in Saudi Arabia, mainly depression are estimated to have high prevalence. More than 6 decades ago, the World Health Organization (WHO) defined health as “a complete state of physical, mental and social well-being, and not merely the absence of disease or infirmity.” Bircher, 2005 defined health as “a dynamic state of well-being characterized by a physical and mental potential, which satisfies the demands of life commensurate with age, culture, and personal responsibility”. Health has been defined by various authors, who have always emphasized its mental component.In recent years, there has been a sharp increase in the number of older persons worldwide. Globally, more than 350 million people of all ages suffer from depression. Elderly persons are more vulnerable to depression. By the year 2020 depression would be the second major cause of disability adjusted life years lost, as reported by the World Health Organization. depressive symptoms are common among older people and are associated with disability, morbidity and mortality. Depression is a mental illness which causes persistent low mood, a sense of despair, and has multiple risk factors.
 Aim of the study: To assessment the determinant and prevalence of depression among elderly attendees in primary health Care center in Makkah Al-Mukarramah.
Methods:Methods: A cross-sectional study was conducted among elderly patients attending to clinic in PHC at Makkah, Saudi Arabia, during the October to December, 2019, validated questionnaires concerning demographic data and knowledge scores on depression among elderly. Our total participants were (400). Results:show that the Family history of depression (70.0%) is the most common clinical variables also show that of the(45.0%) participants have negative depression , (23.0%) have moderate depression,  and the data ranged from(0to 16)by mean+ SD (7.254+2.88).
Conclusion:Depression is associated with a deficiency in the cognitive state, with familial partner risk being an influential factor that may be preventable. Depression constitutes a health problem among Saudi geriatrics in in Makkah Al-Mukarramah, especially among elderly, those having history of chronic diseases and those having sensory impairment. These results provide insight for all health care workers caring for the elderly, researchers in the field of Geriatrics, and health educators into the particular care needs of elderly patients in Makkah, KSA.

Background:
Adequate nutrition is essential for maintaining health and well-being. Apart from nutrition intake through diet, supplement use is prevalent worldwide, supplements are commonly used to replenish the body with essential nutrients that are important in regulating the body’s metabolic processes, The use of supplements, which may be defined as multi-vitamins, single vitamins, single minerals, herbal supplements, oil supplements and any other dietary supplementation, the economic boom in Saudi Arabia indirectly, prompted the use of dietary supplements in the last two decades. Must to investigate the prevalence of dietary supplement use and its association with socio demographic. The Kingdom of Saudi Arabia is a fast growing economic country that has affected its general population in various ways including a transition in daily lifestyle patterns and dietary intake habits.
Aim of thestudy: to Assessment of the prevalence of Using Dietary Supplements Among Physically Active Adults in Makkah ALMukarramah 2019.
 Method:Cross-sectional study design. The current study was conducted at   Sports and Physiotherapy Center and fitness time centers at Holy Capital of Makkah, during the October to December, 2019,Our total participants were (400).
 Results: that a significant difference between age and using supplements in the study while Chi-square 24.413& p-value= 0.001. Most age of participants use supplements from 23-35years were constitute (30.0 %), the gender that no significant difference between using supplements and gender in the study while Chi-square 1.437& p-value 0.911 less than 0.05 , regarding education show that significant difference between education status and using supplements in the study while Chi-square 14.827& p-value more than P=0.022.
.Conclusion: Supplements were commonly used among female students, The prevalence of dietary supplement use was high and was significantly associated with socio demographic and lifestyle factors.A substantial proportion of populations take supplements. Further investigation into the social, psychological and economic determinants that motivate the use of supplements is required, to ensure appropriate use of supplements among adults and the most commonly used supplements.

Background:
      Influenza is a seasonal epidemic with main symptoms that include fever, cough and muscle aches. Fever is a big distinguishing component between a cold and influenza. Some other common symptoms which may or may not be seen with a cold as well are headache, chills, loss of appetite, fatigue and sore throat. diabetes, influenza is a significant burden on the healthcare systems. A significant issue and a significant big health concern happen every year is looking how we could mitigate and manage it and obviously take the burden off the health care system. Diabetic patients, as other chronic diseases patients, could catch the influenza infection, which is a respiratory infection caused primarily by influenza A and Influenza B. Diabetes Mellitus (DM) is a major health problem worldwide. It is a number of metabolic disturbances that is characterized and identified by the presence of hyperglycemia in the absence of treatment.
Aim of the study: to assessment of the Prevalence of Influenza Immunization among Diabetic Patients attending Primary Health Care Center In Makkah Al-Mokarramah,2019.
 Methods: A Cross-sectional analytical study was carried out in the city of Makkah among diabetic patients attending  Primary Health Care Center during  the October to December 2019, the Sample size patients participants.  Our total participants were (300).
Results: shows the majority of participant (39.5%) have average level of total attitude of diabetic patients towards seasonal influenza vaccination followed by (29.5%) of participant weak while Range(7-19) and Mean ±SD(13.065±3.822), X²11.59 P=0.003.Conclusion: Undermining the effect of influenza and misconceptions on the effectiveness of the vaccine could much be improved by increasing awareness and knowledge, seasonal vaccination among diabetics in KSA is low. Level of knowledge and perception are the main barriers to vaccination. Health care provider’s advice may be an important key predictor of previous influenza vaccination and they should continue to educate and encourage all diabetics to get vaccinated for influenza at least once yearly.