Purpose: This study aimed to evaluate the efficacy of tranexamic acid (TXA) in treating melasma through a meta-analysis and systematic review of randomized controlled trials (RCTs). The study focused on identifying associated adverse effects and comparing TXA's effectiveness with other melasma treatments.Materials and methods: Following PROSPERO and PRISMA guidelines, an extensive electronic search was conducted across four databases for RCTs on TXA use in melasma. Inclusion criteria encompassed full-text English articles with specific outcome measures, while studies with high bias risk or non-English publications were excluded. Data were extracted from 22 relevant studies and analyzed using the RevMan software, with heterogeneity identified using I² statistics and forest plots.Results: A total of 22 studies with 1280 patients were included. TXA was administered orally, topically, or via injection, with treatment durations ranging from 8 weeks to nearly 2 years. TXA significantly reduced melasma severity, evidenced by reductions in MASI, mMASI, MI, and hemi-MASI scores. Oral TXA showed the most substantial decrease in MASI scores, followed by injections and topical applications. However, studies exhibited high heterogeneity, particularly in combined treatments. Adverse effects included gastrointestinal discomfort, skin irritation, and menstrual irregularities.Conclusions: TXA is effective in treating melasma, either alone or combined with other treatments. Despite significant reductions in melasma severity, further research is necessary to standardize TXA administration methods and address long-term effects. The high heterogeneity observed suggests a need for more consistent treatment protocols.

Background: Antimicrobial resistance continues to threaten effective infection management worldwide and is driven largely by inappropriate prescribing practices. In Saudi Arabia, the cities of Makkah and Al-Madinah experience intense seasonal healthcare demand due to the annual pilgrimage, creating additional challenges for rational antibiotic use. This study aimed to evaluate physicians’ knowledge, attitudes, and prescribing behaviors related to antibiotics in these high-demand settings. Methods: A cross-sectional analytic study was conducted between June and August 2024 among physicians practicing in Makkah and Al-Madinah, including those participating in Hajj services. A previously validated, structured electronic questionnaire assessed knowledge of common pathogens, perceptions of antimicrobial resistance, prescribing influences, and counseling practices. The survey was distributed electronically to eligible physicians. Descriptive statistics were generated, and associations were examined using appropriate inferential tests with a 95% confidence level. Results: A total of 487 physicians participated. Most respondents (74%) correctly identified major bacterial causes of upper respiratory tract infections, and 90% acknowledged the association between prior antibiotic exposure and resistance. Nonetheless, misconceptions persisted regarding the benefit of antibiotics in viral conditions. Workload and patient expectations influenced prescribing behavior; 77% reported a greater likelihood of prescribing antibiotics during periods of high clinical pressure. While adherence to guideline-based practice was generally reported, variability existed in counseling practices and perceptions of stewardship policies. Conclusions: Although baseline knowledge was satisfactory, contextual and behavioral factors continue to influence prescribing decisions and may contribute to unnecessary antibiotic exposure, highlighting the need for strengthened antimicrobial stewardship strategies in high-demand healthcare environments.

Background: A digital rectal examination (DRE) is a crucial diagnostic examination used to identify various medical conditions by inserting a finger into the patient's rectum to check for abnormalities. Although clinically significant, DRE can be challenging, especially for first-time patients. Reasons for refusal often include misunderstandings about the examination, fear of the way the test is done, and feelings of embarrassment. This study seeks to explore the views, opinions, and perceptions of individuals in the Western region of Saudi Arabia towards DRE. The objective is to guide interventions and improve healthcare practices related to anorectal conditions in this population. Method: In this cross-sectional study, we used a validated questionnaire, which was translated from English into Arabic, before distributing it to the target population. The target population included adults older than 18 years residing in the Western region of Saudi Arabia. Although our initial sample size was determined to be 385, we successfully recruited a larger sample of 1,147 participants. Data were statistically analyzed using IBM SPSS Statistics software for Windows, version 22 (IBM Corp., Armonk, NY). Results: A total of 1,087 eligible participants completed the study questionnaire. Among them, 480 participants (44.2%) demonstrated a good overall awareness and understanding of DRE, while the majority, 607 (55.8%), had poor awareness. University-educated participants exhibited better awareness, with 363 (47.7%) showing good overall awareness compared to 103 (35.2%) of those with only secondary education, a statistically significant difference. Furthermore, 269 (46.7%) of students had a good awareness of DRE compared to 55 (34.8%) of unemployed participants. Notably, 218 (58.4%) of individuals working or studying in the medical field had a good awareness of DRE, compared to 207 (37.2%) in non-medical fields. Conclusion: The majority of individuals showed limited knowledge regarding DRE. The findings suggest increasing public understanding and raising awareness of and importance of DRE for improving healthcare outcomes.

Background Organ donation involves giving organs to help others in need of transplants. It can be carried out while the individual is still alive or after death (e.g., kidney donation). Strict legal requirements and moral principles govern this life-saving action. Because supply is limited and demand is strong, awareness and registration are essential. In Saudi Arabia, despite religious rulings (fatwa) permitting organ donation since 1982, significant gaps persist between transplant demand and donor availability. Objectives This cross-sectional study aimed to evaluate knowledge, attitudes, and barriers regarding organ donation among adults in Makkah. Methods A cross-sectional study was conducted online using Google Forms (Google, Inc., Mountain View, CA) from 04 December to 30 December 2024 to investigate public perspectives on organ donation in Makkah, Saudi Arabia. A convenience sampling strategy was employed, and the questionnaire was distributed via various social media channels, including among adult residents of Makkah aged 18 years or older. Age eligibility was verified by self-report, with responses from individuals under 18 excluded. Associations between categorical variables were assessed using chi-squared tests, with effect sizes reported using Cramer's V. Results The study surveyed 1,184 residents of Makkah to assess public perspectives on organ donation. Most respondents were young (58.1%, n = 688 aged 18-25), female (65.2%, n = 772), and Saudi (94.7%, n = 1,121), with nearly half holding university degrees (47.1%, n = 558). Despite the high willingness to donate to family or friends (72.7%, n = 861), only 8.2% (n = 97) had an organ donor card, and 6.4% (n = 76) had formally signed one. The internet was the primary source of information (45.4%, n = 538), while knowledge about donation eligibility was variable: most correctly identified kidney (63.7%, n = 754) and liver (53.4%, n = 632) as living-donor organs, but some incorrectly believed the heart (4.9%, n = 58) or brain (3.9%, n = 46) could be donated by living donors. Religious beliefs influenced 43.3% (n = 513) of participants, and 29.4% (n = 348) reported beliefs that hinder donation. Most prioritized donating to the sickest patients (87.7%, n = 1,038) and younger recipients. Willingness to donate (defined as possessing or signing a donor card) was significantly associated with knowing a living organ donor (chi-squared test, p < 0.001, Cramer's V = 0.153), absence of religious barriers (p = 0.002, V = 0.099), and perceived personal importance of donation (p < 0.001, V = 0.136). Nearly all participants (91.7%, n = 1,086) agreed that the public needs more information about organ donation. Conclusion This study reveals a significant gap between expressed willingness to donate (72.7%) and actual donor registration (8.2%). The strongest predictors of positive donation attitudes were personal connections to organ donation (14.3% vs. 5.8% willing among those with vs. without knowing a living donor, p < 0.001) and perceived personal importance. Public health interventions should focus on converting positive attitudes into action through simplified registration processes and continued engagement with religious scholars to address misconceptions.

Background: Voluntary blood donation is an essential part of healthcare systems, yet participation in many regions, including Makkah, remains suboptimal. Despite its importance for managing trauma, surgeries, hematologic disorders, and chronic diseases, donation behaviors are influenced by public awareness, attitudes, and perceived barriers. With artificial intelligence (AI) emerging as a promising tool in health education and service delivery, there is a growing interest in its potential to improve donor engagement. This study aimed to assess the knowledge, attitudes, and practices (KAP) related to voluntary blood donation and to evaluate public perceptions of AI-based applications in enhancing donation awareness and participation. Methods: A cross-sectional descriptive study was conducted among 1,847 residents of the Makkah region using a bilingual, self-administered online questionnaire. The survey included five sections: demographics, knowledge of blood donation, attitudes and practices, and engagement with AI tools. Participants were recruited via convenience sampling across social media platforms and institutional channels. Composite scores were computed for knowledge, perceived importance of donation, and AI acceptability. Associations between variables were analyzed using multiple linear and logistic regression models, with p-values