Background: Adequate hand hygiene is considered the most effective measure to reduce transmission of nosocomial pathogens. Aims: To determine the effectiveness of infection control intervention to improve compliance with hand hygiene in the Emergency Department, Al-Leith General Hospital, Saudi Arabia, and evaluate bacterial load on hands as a possible indicator of improvement. Methods: The study consisted of 3 phases: Phase I, measurement of basal hand hygiene compliance level; Phase II, multimodal hand hygiene educational programme was initiated; and Phase III, hand hygiene compliance level was measured again. Data were collected by direct observation of healthcare workers in the emergency department between October 2016 and March 2017, using the standardized World Health Organization method for direct observation, "Five Moments for Hand Hygiene". The intervention comprised health education sessions using direct personal contact. Hands of healthcare workers were sampled during Phases I and III by sterile bag method, and bacterial load was determined. Results: A total of 1374 opportunities for hand hygiene were observed during the triphase study. Implementation of the interventional hand hygiene educational programme significantly improved compliance with hand hygiene guidelines from 30.7% to 45.5% (P < 0.01). Log10 bacterial load per hand dropped from 4.97 (standard deviation = 0.32) to 4.57 (0.47) (P < 0.05). Conclusions: Hand hygiene educational programmes were effective in improving compliance in the emergency department, and bacterial load on hands of healthcare workers could be used as an indicator of improvement in hand hygiene compliance.

Transfusion-transmitted virus (TTV) is a single-stranded DNA virus that was identified in patients with post-transfusion hepatitis of non-A-to-G type. Patients with chronic renal failure on maintenance hemodialysis (HD) have a higher risk of viral infections, and the prevalence of TTV infection is common. The aim of our study was to detect TTV-DNA and its genotype in HD patients. A case-control study compromising of 63 patients on maintenance HD therapy at the Nephrology Center of Central Arar Hospital and 100 healthy individuals who were tested for TTVDNA and its genotype by semi nested-polymerase chain reaction with primers derived from the conserved open reading frame 1 (ORF1) region followed by digestion with NdeI and PstI restriction enzyme. The results show that the prevalence of TTV in HD patients was high and statistically significant; 42.9% compared with 19% in the control group. History of blood transfusion was the only significant predictor, and we found that age of patients, duration of HD, hepatitis B and C infection, aspartate aminotransferase and alanine aminotransferase levels were not significant predictors of TT virus positivity in HD patients. TTV genotype 1 (G1) was found to be the most common genotype among both HD and healthy controls. The prevalence of TTV among HD patients was significantly higher than that in healthy individuals. History of blood transfusion was the only significant predictor of TTV positivity among them. Genotype 1 was the most predominant type among HD and healthy individuals. Further studies on TTV in peritoneal dialysis patients and transplant patients are needed.

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The study's objective was to evaluate the clinical significance of sCD40L in HCV-associated hepatocellular carcinoma (HCV-HCC) patients. Sera concentration of circulating sCD40L and IL-10 were assayed using ELISA in 30 HCVpositive patients with HCC, 30 HCV-positive patients with liver cirrhosis and 30 age-matched healthy volunteers with negative anti-HCV-Ab as a control group. Serum sCD40Lshowed statistically-significant high levels in HCV-HCC patients compared to HCV-cirrhotic patients and normal controls (P < 0.001). Serum sCD40L had higher diagnostic value in HCC patients compared with serum AFP. High sensitivity and specificity of sCD40L was observed compared to AFP (90%, 86.7% and 83% and 80% respectively). Significant positive correlation was detected between serum sCD40L and IL-10(r = 0.85 P < 0.001), AFP (r = 0.62 P < 0.05) and tumour staging (r = 0.5 P < 0.05). The study concluded that sCD40L is a valuable diagnostic tool in early diagnosis and screening for HCV and HCC as well as routine follow up of HCV cirrhosis patients. Assessment of serum IL-10 levels in HCV patients may provide a possible predictive marker for disease progression.

Background Nowadays, E-cigarette use shows a significant increase among adults and youth in many countries, although there is still a public health debate about its relative effects compared to the traditional cigarettes. Objectives To assess the prevalence, perceptions, possible reasons of use, and factors associated with E-cigarettes use among medical students at Taibah University, Kingdom of Saudi Arabia. Methods An internet-based online survey study was conducted between September and November 2019 which contains socio-demographic data, data related to smoking and E-cigarette use, and data related to reasons of E-cigarette use. Results A total of 527 out of 720 students completed an online questionnaire, 15.9% of the surveyed students used E-cigarettes, older age, male, higher college class, those who have ≥ 1 close friend who smokes, family history of smoking, and housemates who smoked E-cigarettes show a significantly higher percentage of E-cigarettes use. The first reason for E-cigarettes use namely that, E-cigarette helps to reduce tobacco consumption with no intention to quit smoking was the highest (89.2%), followed by E-cigarette being less toxic than tobacco (88.4%), and finally E-cigarette helps to avoid having to go outside to smoke (62.05%). Logistic regression analysis showed that sex, more than one close friend who smokes, family history of smoking, and housemates who smoked E-cigarettes were significant factors associate with its use. Conclusion E-cigarette use appears to be relatively common than conventional cigarette among the participants. Our study participants perceived that it can help people quit, less harmful, and less addictive. The most common reason for its use among the study participants was that E-cigarette helps to reduce tobacco consumption in users with no intention to quit smoking.