Background: People with heart failure may have associated comorbidities and illnesses, which are key risk factors for depression. In a tertiary care facility in Riyadh, Saudi Arabia, the relationship between heart failure, depression, and associated comorbidities will be methodologically evaluated. Methods: From January to July 2022, a case-control research was carried out. Patients who had heart failure were considered cases, whereas healthy individuals attending the primary care facility were considered as controls. The exposure was a prior history of heart failure as assessed by the PHQ-9 (Patient Health Questionnaire 9). Score was calculated, and depression severity was categorized (mild, moderate and severe). Results: A total of 800 participants were approached, out of whom 600 fulfilled the inclusion criteria and consented to participate, 420 (70%) participants were enrolled as cases and 180 (30%) as controls. For cases vs controls, mean (SD) age was 59.512± 15.417 and 31.06±5.992 years, 265 (63.1%) and 75 (41.7%) were males, respectively. Odds ratio (OR) (95% CI) of having heart failure and being depressed (PHQ-9) was 3.02 (2.44-3.83), p value <0.0001. The association remained significant even after adjusting for gender and age in Model 1 OR (95% CI): 2.82 (2.27-3.60), p value <0.0001, hypertension and stroke in Model 2 OR (95% CI): 2.87 (2.29-3.71), p value <0.0001 and malignancy and COPD in Model 3 OR (95% CI): 2.94 (2.31-3.85), p value <0.0001. Conclusion: Heart failure and depression had direct relation especially in individuals with certain associated comorbidities as hypertension, stroke, cancer, COPD, and older male patients.

Background: Smoking is one of the leading risk factors that raised mortalities and morbidities significantly. Smoking cessations programs were implemented to reduce the number of smokers. Many factors may influence the smoking cessation including factors related to the treating physician. Objective: To determine smokers' perception and attitude towards smoking cessation when knowing the physician is a smoker. Methods: This was an observational cross-sectional survey study that has been conducted among smokers' patients at King Khalid University Hospital in Riyadh, the estimated sample size was 200 participants. Results: The participants who saw a smoking physician were 90% and 8.8% of them were supported by physicians to quit smoking. The remaining 10% participants reported that they did not see a smoking physician and 15.8% of them were supported by physicians to quit smoking. There was significant correlation between attitude toward smoking cessation and the smoking status and the highest score was found among current smokers and lowest score among ex-smokers (P-value= 0.012). Moreover, the score was highest among those who have history of failed attempt to quit smoking. Lastly, there was no statistically significant difference in scores based on perception and attitude towards smoking cessations when knowing the physician is a smoker. Conclusion: The present study assessed the level of perception and attitude among smokers and the results suggest a different impact of smoker physicians and compared it according to characteristics of smoking. Also, this study showed variations in the behaviors of smoking and cessation, smoking-related barriers that prevent patients from stopping smoking based on physician smoking status.