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This is a retrospective study of the epidemiology of congenital clefts of the lip and palate in babies of Omani nationals born in the Sultanate of Oman between 1989 and 1995. Babies of non-Omani immigrants were excluded from the study. The data were collected from two sources. The first was the Centralized Plastic Surgery Service of Khoula Hospital at Muscat, the capital city of Oman between 1989 and 1995, which registers all oral cleft cases in the country. These data revealed the overall incidence of oral clefts (OC) to be 1.5 per 1000 live births, with incidences of 0.62 per 1000 for combined lip and palate (CLP) cleft, 0.34 per 1000 for cleft lip (CL), and 0.54 per 1000 for isolated cleft palate (CP). The second data source was national delivery records from maternity sections of all hospitals in the country from 1989 to 1995, which include oral clefts as congenital anomalies identified at birth. These statistics were similar to those from the first source for CL/CLP but underestimated the number of isolated cleft palates (CP). The histories of patients attending the Plastic Surgery Clinic of Khoula Hospital during the last year of the study period could be examined in detail. A study of the 177 OC cases registered in 1995 alone revealed associated congenital anomalies in 38.4%. A higher inbreeding coefficient of 0.0294 was noted among oral cleft cases than in the general population, which was calculated at 0.0198. Familial clefts accounted for 23% of all cases. Greater parental age and birth order were found to be associated with increased risk of oral cleft. High temperatures during the tropical desert summers in Oman (when temperatures reach 48°C) do not seem related to the incidence of oral clefts.

BackgroundThe quality of randomized controlled trials from Saudi Arabia is unknown since most are observational studies.ObjectiveTo determine (1) the quantity and quality of randomized controlled trials published from Saudi Arabia, and (2) whether significance of intervention effect varied by study quality.MethodsPubMed, SCOPUS, and Cochrane were searched with keywords for trials published from Saudi Arabia until February 2018. A total of 422 records were identified and screened, resulting in 61 eligible trials for analysis. Two researchers abstracted trial characteristics and assessed quality in seven domains (randomization, allocation concealment, blinding of assessors or participants, incomplete outcome data, selective reporting, and other sources of bias) using the Cochrane Collaboration Risk of Bias Tool.ResultsA majority of the trials (57%) were published during 2010–2018. High risk of bias was present for blinding (outcome: 13%; participants and personnel: 28%). Biases could not be assessed due to lack of information (unclear risk) in the domains of randomization (54%), allocation concealment (44%), and blinding of outcome assessment (57%). When all seven domains were considered together (summary risk of bias), 0% of the trials had low risk, 39% had high risk, and 61% had unclear risk of biases. A greater proportion of high-risk trials had significant intervention effect than unclear-risk trials (79% vs. 67%).ConclusionThe volume and quality of trials in Saudi Arabia was low. More high-quality randomized controlled trials are warranted to address chronic diseases.

Background: Substance use disorders (SUD) are mental health conditions that arise from chronic drug use. There is an increased recognition of this problem in Saudi Arabia. Objective: Conduct a comprehensive review of published literature on SUD to identify knowledge gaps and to guide future research. Methods: PubMed, Embase and Cochrane databases were searched with suitable keywords for SUD publications up to June 10, 2019. Eligible studies (primary research conducted in Saudi Arabia) were organized into three broad domains: (1) risk (or protective) factors of SUD, (2) perspectives on drug use of people who use drugs, and (3) impact on family. The quality of the included studies was assessed with the Newcastle-Ottawa Scale. Results: Of the 113 search records, 23 were eligible for analysis (19 cross-sectional and 4 case-control). All studies were conducted in clinical settings; all but two included males only. There were 4 studies about SUD risk factors, 6 studies about the perspectives of people who use drugs, and none about family impact. None of the crosssectional studies (0%) and 25% of case-control studies were of good quality. Conclusions: The available studies were few in number, weak in methodology, and poor in quality. Quantitative as well as qualitative studies about SUD are warranted in each domain and should represent both genders.

Background and aims The prevalence of internet addiction (IA) varies widely in the Gulf Cooperation Council (GCC) countries (4%–82.6%). We aimed to assess the quality of IA studies from the GCC and pool their data to get an accurate estimate of the problem of IA in the region. Methods A systematic review of available studies was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. PubMed, Embase, and Cochrane Controlled Register of Trials were systematically searched; studies conducted in GCC countries (i.e., Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates) with a validated instrument for internet addiction assessment were eligible. Ten studies were eligible for the systematic review, all of which were included in the meta-analysis. The Newcastle Ottawa Scale was used for quality assessment. Results Nine out of ten of the included studies had either adolescent and/or young adult participants (age < 25). Two studies were of ‘good’ quality, six were of ‘satisfactory’ quality, and two were of ‘unsatisfactory’ quality. The pooled internet addiction prevalence was 33%; it was significantly higher among females than males (male = 24%, female = 48%, P = 0.05) and has significantly increased over time (P < 0.05). Discussion and conclusions One in every three individuals in GCC countries was deemed to be addicted to the internet, according to Young's Internet Addiction Test. A root cause analysis focusing on family structure, environment, and religious practices is needed to identify modifiable risk factors.

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Aim To assess whether expatriate‐specific factors were associated with nurses’ overall job dissatisfaction after controlling for known factors. Background Current evidence about job dissatisfaction among nurses in Saudi Arabia is not specific to expatriate nurses. Specific aspects such as job insecurity, fear of litigation, and language barriers have not been assessed in the context of job dissatisfaction. Introduction The majority of nurses in the Arab Gulf countries are expatriate. The motive for employment here is purely financial because there is no path to permanent residency. Methods This was a cross‐sectional electronic survey of 977 expatriate nurses in Al‐Qassim, Saudi Arabia. The survey included questions on demography, job dissatisfaction (overall and related to salary, workload, and teamwork), job characteristics, job duration as an expatriate, communication issues with patients and doctors, fear of litigation, and job insecurity. We used a hierarchical logistic regression to evaluate whether unique factors were associated with overall job dissatisfaction either as a group, or individually. Results The mean age of the nurses was 32 years, and 19% reported overall job dissatisfaction. The unique expatriate factors as a group contributed significantly to the model. Job insecurity, patient communication problems, and shorter job duration were significantly associated with higher overall job dissatisfaction. Conclusions Job insecurity, job duration, and patient communication were significant correlates of overall job dissatisfaction among expatriate nurses. Implications for nursing policy A longer job contract and organizational initiatives to help new expatriate nurses acculturate will likely decrease feelings of job insecurity and increase job satisfaction.