Background/Objectives: The rational use of medicines, in accordance with the World Health Organization (WHO) guidelines, is crucial for optimizing healthcare outcomes. This cross-sectional study aimed to evaluate drug prescribing patterns and assess prescription completeness based on the WHO core drug use criteria. A comprehensive analysis was conducted at the University Clinic in the Northern region, Kingdom of Saudi Arabia (KSA). Methods: The study assessed drug prescribing patterns and examined prescription completeness by analyzing various parameters recommended by the WHO core drug use criteria. Results: Upon analyzing the 615 prescriptions, it was observed that each prescription had a mean of 2.56 prescribed drugs. Multiple medicines per prescription were prevalent in 71.4%, whereas polypharmacy was evident in 2.9%. Analgesics were the most frequently prescribed medication, accounting for 50.4% of the prescriptions, followed by supplements (31.7%), decongestants (16.1%), cough syrup (12%), and antihypertensive and diabetes treatments at 17%. Furthermore, antimicrobials were prescribed in 21.5% of the prescriptions. During the evaluation, it was found that 19.8% of the prescriptions were incomplete, lacking important information on dosing, duration, and drugs not suited to the diagnosis. Conclusions: Most of the parameters evaluated in this study were determined to fall outside the range of recommended guidelines criticized by the WHO. As a result, the implementation of efficient intervention programs, such as education initiatives, is recommended to enhance the practice of rational drug use. Contribution: This study highlights the importance of improving prescription indicators at the national level, focusing on both medication prescribing characteristics and prescription quality as a practice.

Methicillin-resistant Staphylococcus aureus (MRSA) is a devastating global health concern. Hypervirulent strains are on the rise, causing morbidities and mortalities worldwide. In tertiary care hospitals, critically ill patients, those undergoing invasive procedures, and pediatric and geriatric patients are at risk. It is not fully clear how strains adapt and specialize in humans and emerge despite the well-established commonality of the S. aureus genome from humans and animals. This study investigates the influence of age-, gender-, and source-specific profiles (clinical, intensive care unit (ICU vs. non-ICU)) on the evolution of hospital-associated (HA)-MRSA versus community-associated (CA)-MRSA lineages. A total of 253 non-duplicate S. aureus isolates were obtained from May 2023 to March 2025. The patients were stratified by age and gender in ICUs and non-ICUs. Standard microbiology methods and Clinical and Laboratory Standards Institute (CLSI) guidelines were used for identification and susceptibility testing, with cefoxitin and oxacillin disk diffusions and molecular diagnosis confirming MRSA. Mann–Whitney U and Chi-square tests assessed the demographic distributions, clinical specimen sources, and MRSA/methicillin-sensitive S. aureus (MSSA) prevalence. Of 253, 41.9% originated from ICUs (71% male; 29% female) and 58.1% from non-ICU wards (64% male; 36% female). In both settings, MRSA colonized the two extremes of age (10–29 and 70+) for males and females, with different mid-life peaks or declines by gender. However, the overall demographic distribution did not differ significantly between the ICU and non-ICU groups (p = 0.287). Respiratory specimens constituted 37% and had the highest MRSA rate (42%), followed by blood (24.5%) and wounds (10.3%). In contrast, MSSA dominated wounds (20.3%). Overall, 73.9% were resistant to cefoxitin and cefotaxime, whereas vancomycin, linezolid, daptomycin, and tigecycline remained highly effective. Younger non-ICU patients (10–29) had higher MSSA, whereas older ICU ones showed pronounced HA-MRSA profiles. By the virtue of methicillin resistance, all MRSA were classified as multidrug resistance. Thus, MRSA colonization of the two extremes of life mostly in ICU seniors and the dominance of invasive MSSA and CA-MRSA patterns in non-ICU youth imply early age- and gender-specific adaptations of the three lineages. MRSA colonizes both ICU and non-ICU populations at extremes of age and gender specifically. High β-lactam resistance underscores the importance of robust stewardship and age- and gender-specific targeting in screening. These findings also indicate host- and organ-specificity in the sequalae of MSSA, CA-MRSA, and HA-MRSA evolutionary dynamics, emphasizing the need for continued surveillance to mitigate MRSA transmission and optimize patient outcomes in tertiary care settings.

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a devastating global health concern. Hypervirulent-strains are on the rise causing morbidities and mortalities worldwide. In tertiary care hospitals, critically-ill, invasive-procedures, pediatrics, and geriatrics are at risk. It is not clear how the strains specialized in humans in a clonal-genome. This study investigates the influence of age-, gender-, and source- (clinical, ICU vs. non-ICU)-specificity profiles in the evolution into hospital-associated (HA-MRSA) versus community-associated (CA-MRSA) lineages. Methods: 253 non-duplicate S. aureus isolates were obtained from May 2023 to March 2025). Patients were stratified by age and gender in ICU and non-ICUs. Standard microbiology methods and CLSI guidelines were used for identification and susceptibility testing, with cefoxitin and oxacillin disk diffusions and molecular diagnosis confirming MRSA. Mann-Whitney U and Chi-square tests assessed demographic distributions, clinical specimen sources, and MRSA/MSSA prevalence. Results: Of 253, 41.9% originated from ICUs (71% male, 29% female) and 58.1% from non-ICU wards (64% male, 36% female). In both settings, MRSA colonized the two extremes of age (10–29 and 70+) for males and females, with different mid-life peaks or declines by gender. However, the overall demographic distribution did not differ significantly between ICU and non-ICU groups (p = 0.287). Respiratory specimens constituted 37% and had the highest MRSA rate (42%), followed by blood (24.5%) and wounds (10.3%). In contrast, MSSA dominated wound (20.3%). Overall, 73.9% were resistant to cefoxitin and cefotaxime, whereas vancomycin, linezolid, daptomycin, and tigecycline remained highly effective. Younger non-ICU patients (10–29) had higher MSSA, whereas older ICU ones showed pronounced HA-MRSA profiles. By the virtue of methicillin-resistance, all MRSA were classified as multidrug resistance. Thus, MRSA colonization of the two extremes of life mostly in ICU seniors and the dominance of invasive MSSA and CA-MRSA patterns in non-ICU youth, imply early age- and gender-specific adaptations of the three lineages. Conclusion: MRSA colonizes both ICU and non-ICU populations at extremes of age gender-specificically. High β-lactam-resistance underscores the importance of robust stewardship and age- and gender-specific targeting in screening. These findings also indicate host- and organ-specificity in sequalae of MSSA, CA-MRSA, HA-MRSA evolutionary-dynamics emphasizing the need for continued surveillance to mitigate MRSA transmission and optimize patient outcomes in tertiary care settings.

The mechanism of menstrual-disturbance post-COVID-19 vaccination is subtle. Although direct interactions with molecular vaccines per se is reported, albeit the indirect stimulants, factors, patient demographics involved are not clear. Stress and uterine dysbiosis are largely overlooked despite the similar neurochemicals to that in the gut-brain-axis. Thus, more surveillance on women’s responses post-vaccination are needed. We aimed to survey the increasing trends in women’s menstrual disturbance post-pandemic vaccination for frequency, potential factors, patients’ demographics, and vaccine types involved using a self-administered web-based online public question-naire sent to different regions of Saudi Arabia. We collected data on 1372 women who developed menstrual ir-regularity after vaccination and used statistical analysis to examine and identify associated factors. In 1372 females; 61.1% (n=838) aged 19-29 years, 94.2% (n = 1292) Saudi citizens, 66.4% (n=911) graduates, 70% (n=965) were single, and only 15% (n=205) had chronic diseases. About 96.5% (n=1285) of 97% (n=1332) had two doses, mostly Pfizer's first and second doses (82% and 78, respectively) while ~3.5% (n=47) had one. No acute COVID infection appeared. The majority (77%; n=1057) reported no issues pre-vaccination except 23%(n=315) of whom 43% (n=135) reported worsening issues post-vaccination. However, 47.2% (n=629) complained only post-vaccination particularly after dose-2 (59% (n=370). These were mostly multiple simultaneously occurring issue in 75% (n=471) on cycle-timing disruptions the rest were low frequencies of decreased blood, missed periods, increased blood volume, pain, or increased bleeding. Potential reasons were fear, stress, mental health, and/or emotional problems in 51% (n=674), while 53% (n = 701) were worried about the pandemic. Although proportional differences between age-groups were significant (P =0.05), the relative frequency was highest in ages 30-39 (51%). Significant proportional differences in groups of (Pfizer, Moderna, Oxford, Don't know) occurred in outcomes post first (0.047) and second (0.049) doses. However, relative frequencies of outcomes were higher in Pfizer and Moderna. Logistic regression revealed postgraduate [OR=2.11 (0.98-4.72), P = 0.015) employment [OR=2.18 (0.95-4.86), P = 0.049]and Pfizer vaccine [OR = 2.09 (0.96-4.10), P= 0.029] two doses [OR=3.21(1.23-5.21), P = 0.030] as significant predictors. Mental health and emotional factors such as fear, worries, and emotional problems that triggered stress were also associated [OR=1.78 (0.76-3.21), P=0.033]. However, all other variables were not associated with menorrhea disturbances. Thus, menstrual disturbance was significantly associated with vaccina-tions. Fear, stress, mental health, worries about the pandemic, and/or emotional problems were the major reasons reported. Apart from direct viral interactions, these findings are consistent with the emerging evidence on indirect stress- and microbiome-induced stimulations. This is plausible in the absence of significant factors related to old-age, chronic diseases, and lifestyle-behaviors. These findings have significant implications in women’s health, gender-based interpretation, and vaccine improvement strategies. Future vertical studies on cortisol response and the consequence of uterine-dysbiosis in manipulating immune-response is warranted.

The increased menstrual disturbances post-vaccination remain unclear. We examined factors, types, frequencies, and emotional challenges. We used a self-administered online questionnaire with the IBM-based SPSSv-24-Windows software for analysis. Of 1372 females, 61.1% (n = 838) were aged 19–29 years, 94.2% (n = 1292) were Saudis, 66.4% (n = 911) were graduates, 70% (n = 965) were single, and 15% (n = 205) had chronic diseases. Moreover, 96.5% (n = 1285/1332) had two vaccine doses, mostly Pfizer’s first- and second doses (82% and 78, respectively), while 3.5% (n = 47) only had one. Vaccine groups significantly differed (Pfizer, Moderna, Oxford, and do not know) after the first (0.047) and second (0.049) doses, while Pfizer vaccines were predictive [OR = 2.09 (0.96–4.10), p = 0.029] at two-doses [OR = 3.21 (1.23–5.21), p = 0.030]. No acute COVID appeared. The majority (77%; n = 1057) had no issues, except, in a subgroup of 23% (n = 315) of participants, 43% (n = 135) experienced worsening issues. However, 47.2% (n = 629) complained only post vaccination. Most issues were (75%; n = 471) cycle-timing disruptions; the rest were minor (decreased blood or bleeding, missed-periods, or pain). Other potential reasons were fear, stress, and mental health problems, which occurred in 51% (n = 674) of the group, while 53% (n = 701) were worried. Intriguingly, the menstrual issues in the remaining 47% (n=631) who were not worried could be due to a direct molecular vaccine interaction, irrespective of any mental issue ([OR = 1.78 (0.76–3.21), p = 0.033]. Age proportionalities were significant (p = 0.05) in the 30–39 year-old group (51%). Postgraduate education [OR = 2.11 (0.98–4.72), p = 0.015) and employment [OR = 2.18 (0.95–4.86), p = 0.049] were also predictors. These findings have significant implications in women’s health and vaccine improvement. Future studies on diverse factors are warranted.