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These days, mobile computing devices are ubiquitous and are widely used in almost every facet of daily life. In addition, computing and the modern technologies are not really coexisting anymore. With a wide range of conditions and areas of concern, the medical domain was also concerned. New types of technologies, such as context-aware systems and applications, are constantly being infused into the medicine field. An IoT-enabled healthcare system based on context awareness is developed in this work. In order to collect and store the patient data, smart medical devices are employed. Context-aware data from the database includes the patient's medical records and personal information. The MRIPPER (Modified Repeated Incremental Pruning to Produce Error) technique is used to analyze and classify the data. A rule-based machine learning method is used in this algorithm. The rules for analyzing datasets in order to make predictions about heart disease are framed using this algorithm. MATLAB is used to simulate the proposed model's performance analysis. Other models like random forest, J48, CART, JRip, and OneR algorithms are also compared to validate the proposed model's performance. The proposed model obtains 98.89 percent accuracy, 96.76 percent precision, 99.05 percent sensitivity, 94.35 percent specificity, and 97.60 percent f-score. Predictions for subjects in the normal and abnormal classes were both accurate with 97.38 for normal and 97.93 for abnormal subjects.

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Gestational diabetes mellitus (GDM) is the most common complication of pregnancy. The disease is on the rise worldwide with deleterious consequences on the fetus, mother, and children. The study aimed to review the role of lifestyle in the prevention of GDM. We searched PubMed, SCOPUS, Web of Science, Cochrane Library, EBSCO, and Google Scholar from the first published article up to December 2021; articles were eligible if they were controlled trials, prospective cohorts, and case-control. Out of 5559 articles retrieved, 66 full texts were screened, and 19 studies were included in the meta-analysis. (6 studies assessed the effects of diet, and 13 were on exercise). The dietary intervention showed significant positive effect on GDM, odd ratio = 0.69, 95% CI, 0.56-84, P-value for overall effect = 0.002. The DASH diet was better than Mediterranean Diet (odd ratio, 0.71, 95% CI, 68-74, P-value < 0.001). Regarding exercise, no significant prevention was evident on GDM, odd ratio, 0.77, 95% CI, 0.55-1.06, P-value = 0.11. However, a significant prevention of gestational diabetes was found when the exercise was mild-moderate (odd ratio = 0.65, 95% CI, 0.53-80, P < 0.0001) and started in the first trimester (odd ratio, 0.57, 95% CI, 0.43-0.75, P < 0.0001. No significant effect was found when the exercise was vigorous (odd ratio = 1.09, 95% CI, 0.50-2.38, P = 0.83) and started during the second trimester of pregnancy (odd ratio, 1.08, 95% CI, 0.65-1.80, P = 0.77. Diet and early mild-moderate exercise were effective in GDM prevention. Exercise during the second trimester and moderate-vigorous were not. Further studies assessing the type, duration, and frequency of physical activity are needed.

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OBJECTIVES: This study was conducted to assess differences in the prevalence of overweight and obesity among young men from twelve Middle Eastern and Asian countries who live in Riyadh, Saudi Arabia. METHODS: This study used a cross-sectional design and was conducted in Riyadh, Saudi Arabia. The body weight and height of 3600 young men (aged 20 to 35 years) were measured using standardized methods. The sociodemographic characteristics of the participants were collected using face-to-face interviews. RESULTS: Overweight and obesity was reported in 48.3% of the study sample; 42.2% were overweight, and 6.2% were obese. The overweight and obesity rate was associated with the nationality of the participants. The lowest rate of overweight and obesity was observed among participants from Bangladesh (19.4%), while the highest rate was reported among participants from Egypt (67.5%). Older age and longer residency duration were associated with overweight and obesity risk among the subjects. CONCLUSION: The outcomes revealed a fairly high prevalence of overweight and obesity among participants. The notable disparity in overweight and obesity rates among participants of different nationalities is confirmed. The risk of overweight and obesity among young men in Saudi Arabia is associated with nationality, age, and residency duration.

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Internet of Things (IoT) technology has recently been applied in healthcare systems as an Internet of Medical Things (IoMT) to collect sensor information for the diagnosis and prognosis of heart disease. The main objective of the proposed research is to classify data and predict heart disease using medical data and medical images. The proposed model is a medical data classification and prediction model that operates in two stages. If the result from the first stage is efficient in predicting heart disease, there is no need for stage two. In the first stage, data gathered from medical sensors affixed to the patient's body were classified; then, in stage two, echocardiogram image classification was performed for heart disease prediction. A hybrid linear discriminant analysis with the modified ant lion optimization (HLDA-MALO) technique was used for sensor data classification, while a hybrid Faster R-CNN with SE-ResNet-101 modelwass used for echocardiogram image classification. Both classification methods were carried out, and the classification findings were consolidated and validated to predict heart disease. The HLDA-MALO method obtained 96.85% accuracy in detecting normal sensor data, and 98.31% accuracy in detecting abnormal sensor data. The proposed hybrid Faster R-CNN with SE-ResNeXt-101 transfer learning model performed better in classifying echocardiogram images, with 98.06% precision, 98.95% recall, 96.32% specificity, a 99.02% F-score, and maximum accuracy of 99.15%.

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Ripe date fruits contain phenolic compounds which possess a high antioxidant activity. The current review was carried out to evaluate total phenolic content in ripe date fruits. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was followed during the review process. Relevant studies published from inception up to March 2019 were retrieved from three databases. Study selection was performed based on specific inclusion criteria. A total of twenty-two articles were selected and included in the present review. Data collected from these studies were organized, pooled, and analyzed using descriptive statistics. Total phenolic content means and medians have been reported for the collected ripe date fruit samples for each included study and pooled data. The results suggested that ripe date fruits contain a potent total phenolic content that can contribute mainly to their antioxidant properties.

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INTRODUCTION: Dyslipidemia is a key clinical abnormality among diabetes mellitus (DM) patients, which heightens their risk of cardiovascular events. Data on the serum lipid profile of type 2 DM (T2DM) patients in Saudi Arabia are scarce. This study therefore aimed to establish dyslipidemia prevalence in a sample of adult T2DM patients in Saudi Arabia and to investigate its associated factors. PATIENTS AND METHODS: A cross-sectional survey was applied to 400 adult T2DM outpatients in attendance at a diabetic center clinic in Tabuk, Saudi Arabia between September 2017 and December 2018 using convenience sampling. Structured questionnaires gathered data relating to the potential risk factors for dyslipidemia. Data on fasting blood glucose (FBG), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels were collected from all participants along with their height and weight measurements. Multivariate logistic regression analysis was then used to evaluate the associated risk factors for dyslipidemia. RESULTS: Of the sampled outpatients, 47.8% had high TC levels, 39.0% had high LDL-C, 35.5% had low HDL-C, 42.8% had high TG levels, and 66.5% had a minimum of one abnormal lipid level (dyslipidemia). The risk factors associated with dyslipidemia were an age of >40 years (adjusted odds ratio [AOR] = 1.96, 95% CI 1.19-3.22), irregular exercise (AOR = 2.90, 95% CI 1.21-6.92), a family history of T2DM (AOR = 3.72, 95% CI 2.22-6.23), having had T2DM for >7 years (AOR = 2.42, 95% CI 1.46-3.99), and overweight (AOR = 2.61, 95% CI 1.49-4.58) or obesity (AOR = 2.50, 95% CI 1.24-5.05). CONCLUSION: Dyslipidemia prevalence was found to be high among T2DM patients. Therefore, a compressive mechanism is needed which can screen, treat, and inform them about dyslipidemia and its risk factors, especially modifiable ones such as obesity and exercise.

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Toxoplasma gondii (T. gondii), which infects many warm-blooded animals including humans, causes toxoplasmosis, a globally widespread condition. To date, no research has explored the overall T. gondii infection seroprevalence among women in Saudi Arabia, nor have the risk factors associated with the infection been examined in the Saudi Arabian context. The present systematic review and meta-analysis therefore aimed to investigate toxoplasmosis seroprevalence based on previous study samples of Saudi women of reproductive age, and to establish the potentially risk factors in this national context. PubMed, Science Direct, and Scopus were searched for studies on T. gondii seroprevalence among women in mainland Saudi Arabia published between January 2000 and December 2017. Seroprevalence with 95% CI was presented for each study, and point estimates and their 95% CIs of pooled seroprevalence were then calculated. Twenty papers were eligible for inclusion, with samples totaling 13,597 females of childbearing age (ie, between 15 and 49 years) covering various regions of Saudi Arabia. The pooled estimation for T. gondii prevalence using a random-effect model was calculated as 27.8% (95% CI =20.6%-36.3%). A significant association was observed between age and T. gondii seroprevalence. This review represents the first comprehensive and systematic evaluation of T. gondii infection seroprevalence among Saudi Arabian women, and reports a high prevalence of Toxoplasma infection. Further research is required to support the development of more cost-effective preventive strategies.

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Vitamin D deficiency is currently a worldwide epidemic. Middle Eastern countries, including Saudi Arabia, have high vitamin D deficiency prevalence, most prominently among women, despite their plentiful year-round sunshine. Previous research investigating vitamin D status among Saudi women of reproductive age (15-49 years) is scarce, and no study has used a nationally representative sample, so this review quantified overall hypovitaminosis D prevalence among women in Saudi Arabia and explored the associated risk factors. The Web of Science, Scopus, and Medline databases were searched for prior studies in Saudi Arabia exploring vitamin D status among women of reproductive age, published between January 1, 2000 and May 25, 2017. Data were extracted from the identified studies, and a random effects model meta-analysis established the overall hypovitaminosis D prevalence. The initial search yielded 223 possibly relevant articles; 13 were confirmed as eligible, with samples totaling 2877 women aged between 15 and 49 years. Meta-analysis revealed a mean serum 25-hydroxyvitamin D, 25(OH)D, level of 13.1 ng/mL (95% confidence interval [CI]: 11.6-14.6) and an overall prevalence of hypovitaminosis D, defined as 25(OH)D < 30 ng/mL, of 77.4% (95% CI: 63.2-87.3), mostly due to insufficient sunlight exposure and low dietary vitamin D intake. There is therefore a need for a national strategy to raise vitamin D levels among women in Saudi Arabia by advising them on natural vitamin D sources, and recommending the timing and duration of sun exposure, while also defining a national approach to vitamin D fortification and supplementation.

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BACKGROUND: Although the prevalence of type 2 diabetes mellitus (T2DM) is rising sharply in Saudi Arabia, data on glycemic control, crucial to reducing diabetes mellitus complications, remain scarce. This study therefore investigated glycemic control status and the factors influencing poor glycemic control among adult T2DM patients in Saudi Arabia. METHODS: This cross-sectional study examined 423 T2DM patients at a diabetic center in Tabuk, Saudi Arabia between September 2016 and July 2017. Glycemic levels were measured via fasting blood glucose (FBG) levels, and "poor glycemic control" was defined as FBG >130 mg/dL. Poor glycemic control's risk factors were identified using a logistic regression. RESULTS: In the sample, 74.9% of the patients had poor blood glycemic control. Logistic regression revealed that T2DM patients had an increased chance of poorly controlled diabetes if they had family histories of diabetes (adjusted odds ratio [AOR] =7.38, 95% CI 4.09-13.31), longer diabetic durations (AOR =2.33, 95% CI 1.14-4.78 for 5-10 years and AOR =5.19, 95% CI 2.50-10.69 for >10 years), insufficient physical exercise (AOR =19.02, 95% CI 6.23-58.06), or were overweight (AOR =3.79, 95% CI 2.00-7.18), or obese (AOR =5.35, 95% CI 2.72-12.59). CONCLUSION: A high proportion of the sampled patients had poor glycemic control, therefore, health care professionals should manage the associated risk factors to limit disease complications and improve the health of patients with diabetes.

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BACKGROUND: Prior data on iron deficiency anemia's (IDA) prevalence and associated risk factors among female university students are scarce in the Saudi Arabian context. This study therefore recruited a sample of female students at the University of Tabuk, Saudi Arabia, to investigate IDA prevalence and risk factors and fill the identified research gap. METHODS: A cross-sectional study of 200 apparently healthy female students aged between 19 and 25 years was performed between February and June 2016. Data on the participants' sociodemographics, diet, health, anthropometry, and hematological and biochemical iron status indices were gathered. A logistic regression analysis then revealed the IDA risk factors. RESULTS: The IDA prevalence was 12.5%. The factors associated via logistic regression with an elevated anemia risk were inadequate iron and vitamin C intakes, infrequent (≤2 times per week) consumption of red meat, frequent (≥2 times per week) tea consumption, and a past personal history of IDA. CONCLUSIONS: The findings suggest that focused education and awareness strategies are needed to improve nutritional habits by encouraging the consumption of rich dietary iron sources and by raising awareness of the food and drinks which facilitate or hinder the bioavailability of iron.

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OBJECTIVES: Toxoplasma gondii (T. gondii) is a serious public health issue, but limited data has been published to date on the seroprevalence of T. gondii infection in Saudi Arabia. Therefore, this study aimed to establish the seroprevalence and risk factors of T. gondii infection using a sample of females enrolled at a university in Northern Saudi Arabia. METHODS: Using a cross-sectional research approach, we recruited a convenience sample of 180 healthy females studying at the University of Tabuk between February and June 2016. We used a questionnaire to gather sociodemographic data on the participants to establish the risk factors leading to exposure to toxoplasma. Blood samples were taken from the participants and analyzed to detect T. gondii antibodies (immunoglobulin M and immunoglobulin G) via the enzyme-linked immunosorbent assay technique. Multivariate logistic regression modeling was employed to establish the potential predictor variables for T. gondii infection. RESULTS: Of the 180 participants, 17 (9.4%) were seropositive for T. gondii IgG. None tested positive for IgM antibodies exclusively. The sole variable positively associated with seropositive T. gondii IgG was the participants' consumption of raw, unwashed fruit or vegetables (odds ratio = 3.36, 95% confidence interval: 1.11-10.22). CONCLUSIONS: Our findings emphasize the need for higher awareness of toxoplasmosis in Saudi Arabia, specifically knowledge of the way toxoplasma infection occurs so that women can more easily avoid it. Large-scale research is therefore required to inform the design of future public health interventions.

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BACKGROUND: A high hypovitaminosis D prevalence has repeatedly been reported in Middle Eastern countries. Previous data regarding the vitamin D status of young women in Saudi Arabia and the related hypovitaminosis D risk factors are scarce, so this research assessed hypovitaminosis D prevalence and its risk factors among apparently healthy female university students in Tabuk, Saudi Arabia. METHODS: This cross-sectional research used a convenience sample of healthy female students (n = 180) aged between 19 and 25 years in May 2016. Information was gathered on the participants' sociodemographics, health, lifestyle, dietary intakes, anthropometry, and serum 25-hydroxyvitamin D (25(OH)D), and a logistic regression analysis was performed to assess hypovitaminosis D risk factors. RESULTS: The sample's hypovitaminosis D prevalence (25(OH)D <30 ng/mL) was 80.6%. The main determinants of hypovitaminosis D were as follows: urban residence (odds ratio [OR] = 6.54; 95% confidence interval [CI], 2.74-5.63), rare sun exposure (OR = 6.14; 95% CI, 2.15-17.55), and insufficient vitamin D intake (OR = 2.50; 95% CI, 1.07-5.81). CONCLUSIONS: The findings emphasize that despite plentiful sunshine, Saudi Arabia and the Middle East face a vitamin D deficiency epidemic. Vitamin D status must therefore be assessed at the national level so that strategies aimed at boosting vitamin D levels can be instigated.

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BACKGROUND: Breast milk contains all the nutrients infants need for their first 6 months of life. However, only a minority of Saudi Arabian mothers exclusively breastfeed, so the influencing factors must be examined to encourage more to do so. The study aimed to determine the prevalence of exclusive breastfeeding at 6 months and its associated factors in Tabuk, North West Saudi Arabia. METHODS: A total of 589 mothers of healthy infants aged between 6 and 24 months were interviewed while attending Well-Baby Clinics within 5 primary health care centers. Interviews deployed a structured questionnaire to collect sociodemographic information and detailed data concerning breastfeeding practices. A logistic regression analysis was then performed on the data to identify the factors independently associated with exclusive breastfeeding practice for infants at 6 months. RESULTS: Exclusive breastfeeding was practiced by 31.4% of mothers for the first 6 months of their infant's life. The logistic regressions indicated that exclusive breastfeeding at 6 months was less likely to be practiced by working mothers, Saudi nationals, and for babies born via cesarean delivery or at low birth weights. Conversely, the mother's awareness of the recommended exclusive breastfeeding duration was positively associated with exclusive breastfeeding. CONCLUSIONS: Programs promoting 6 months of exclusive breastfeeding should target high-risk groups. Two factors identified by this study are modifiable: working mothers and mothers' awareness of the exclusive breastfeeding duration recommendation. Strategies to improve exclusive breastfeeding rates should therefore focus on workplace facilities and increasing awareness of the exclusive breastfeeding recommendation.

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BACKGROUND: Breastfeeding supplies all the nutrients that infants need for their healthy development. Breastfeeding practice is multifactorial, and numerous variables influence mothers' decisions and ability to breastfeed. This review identifies the factors potentially affecting the timely initiation of breastfeeding within an hour after birth and exclusive breastfeeding in the first 6 months in Middle Eastern countries. METHODS: The Medline, ScienceDirect, and Web of Science databases were keyword-searched for primary studies meeting the following inclusion criteria: (1) publication in the English language between January 2001 and May 2017, (2) original research articles reporting primary data on the factors influencing the timely initiation of breastfeeding and/or exclusive breastfeeding, (3) the use of World Health Organization definitions, and (4) Middle Eastern research contexts. A random effect model was used to establish the average prevalence of the timely initiation of breastfeeding and exclusive breastfeeding in the Middle East. RESULTS: The review identified 19 studies conducted in Saudi Arabia (7), Iran (3), Egypt (2), Turkey (2), Kuwait (1), the United Arab Emirates (1), Qatar (1), Lebanon (1), and Syria (1). The meta-analysis established that 34.3% (confidence interval [CI]: 20.2%-51.9%) of Middle Eastern newborns received breastfeeding initiated within an hour of birth, and only 20.5% (CI: 14.5%-28.2%) were fed only breast milk for the first 6 months. The 8 studies exploring breastfeeding initiation most commonly associated it with the following: delivery mode, maternal employment, rooming-in, and prelacteal feeding. The 17 studies investigating exclusive breastfeeding most frequently linked it to the following: maternal age, maternal education, maternal employment, and delivery mode. CONCLUSIONS: Middle Eastern health care organizations should fully understand all the determinants of breastfeeding identified by this review to provide suitable practical guidance and advice to help new mothers to overcome barriers where possible and to contribute to improving infant and maternal health in the region.

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Background: Establishing understanding of infants' dietary intakes can support interventions to improve their diets and overall health. Because information on the dietary intakes of infants aged ≤12 months in Saudi Arabia is scarce, this study examined the diets of infants aged 6 and 12 months in Saudi Arabia and determined their main dietary sources of total energy and macronutrients. METHODS: A crosssectional dietary survey employing a single 24-hour recall was performed between May and December 2015 with a sample of mothers of 278 healthy 6-month-old and 259 12-month-old infants. An analysis of the dietary intake data determined the nutrient intake adequacy and the percentage contributions of foods to energy and macronutrient intakes. RESULTS: The respective mean daily energy intakes of the 6-month-old and 12-month-old infants in the study were 703 kcal and 929 kcal. Both age groups recorded adequate nutrient intakes, with the exception that the 6-month-olds' mean vitamin D intake fell below the recommended Adequate Intake (AI), and the 12-month-olds' intakes of omega-6 fatty acids and vitamin D were also below the AI, along with their iron intake which fell short of the Recommended Dietary Allowance (RDA). CONCLUSION: The data generated here will assist health professionals in planning interventions which aim to improve infants' diets and to offer guidance to parents on the appropriate selection of food for their infants.

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BACKGROUND: The identification of the factors most closely associated with the initiation of breastfeeding is a vital first step in designing strategies to promote breastfeeding. The study therefore aimed to identify the factors that may be associated with the initiation of breastfeeding in the first 48 h after giving birth among mothers in Tabuk, Saudi Arabia. METHODS: This cross-sectional study was based on a sample of 671 mothers of infants aged up to 24 months at five primary healthcare centers between May and September 2015. A structured questionnaire was used to gather general sociodemographic data along with more detailed information on breastfeeding. A logistic regression analysis was then performed to establish the factors which were independently associated with the mothers' initiation of breastfeeding. RESULTS: Breastfeeding was initiated by 92.7 % of mothers within the first 48 h after childbirth. Breastfeeding initiation within the first 48 h of childbirth was lower in women who gave birth by caesarean section (Adjusted Odds Ratio [AdjOR] 0.31, 95 % Confidence Interval [CI] 0.17, 0.57), and had preterm (AdjOR 0.29, 95 % CI 0.12, 0.70) or low birth weight infants (AdjOR 0.35, 95 % CI 0.17, 0.75). CONCLUSIONS: Each variable presents an important barrier to breastfeeding initiation. Suitable hospital policies and staff training are needed to support mothers in quickly initiating breastfeeding, and to discourage the use of infant formula in hospital. To encourage higher rates of exclusive breastfeeding in Saudi Arabia, additional support is required for mothers at a higher risk of failing to initiate breastfeeding in a timely manner.

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Mothers' instigation of complementary feeding before their infant reaches 6 months old risks shortening their breastfeeding duration, and high morbidity and mortality for their child. Complementary feeding practices require further investigation in Saudi Arabia. The present study aims to evaluate complementary feeding practices, and to establish which factors are associated with the early introduction of complementary feeding in the Saudi Arabian context. Cross-sectional research was conducted with 632 mothers of infants aged between 4 and 24 months attending five primary health care centers (PHCCs) between July and December 2015 in Saudi Arabia. Data on participants' socio-demographic characteristics and complementary feeding practices were collected via structured questionnaires. A regression analysis identified the factors associated with the early introduction of solid foods, defined as before 17 weeks. 62.5% of the study's infants received solid foods before reaching 17 weeks old. The maternal factors at higher risk of early introduction of solids were: younger age; Saudi nationality; shorter education; employment within 6 months post-birth; caesareans; not breastfeeding fully for six weeks post-birth, and living in low-income households. Complementary feeding prior to 6 months postpartum was common in Saudi Arabia. Public health interventions are needed to reduce early complementary feeding, focusing on mothers at highest risk of giving solids too early.

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