Objective:To assist healthcare providers in evidence-based clinical decision-making for the management of overweight and obese adults in Saudi Arabia.Methods:The Ministry of Health, Riyadh, Kingdom of Saudi Arabia assembled an expert Saudi panel to produce this clinical practice guideline in 2015. In collaboration with the methodological working group from McMaster University, Hamilton, Canada, using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, which describes both the strength of recommendation and the quality of evidenceResults:After identifying 11 questions, corresponding recommendations were agreed upon as guidance for the management of overweight and obese adults. These included strong recommendations in support of lifestyle interventions rather than usual care alone, individualized counseling interventions rather than generic educational pamphlets, physical activity rather than no physical activity, and physical activity in addition to diet rather than diet alone. Metformin and orlistat were suggested as conditional recommendations for the management of overweight and obesity in adults. Bariatric surgery was recommended, conditionally, for the management of obese adults (body mass index of ≥40 or ≥35 kg/m2 with comorbidities).Conclusions:The current guideline includes recommendation for the non-pharmacological, pharmacological, and surgical management of overweight and obese adults. In addition, the panel recommends conducting research priorities regarding lifestyle interventions and economic analysis of drug therapy within the Saudi context, as well as long term benefits and harms of bariatric surgery.

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Background: Chronic migraine (CM) poses a significant burden for patients, and it has multiple diagnostic and managemental challenges, particularly among primary health-care physicians (PCPs). Objectives: The objective of this study is to assess the levels of knowledge regarding CM diagnosis and management among PCPs and to explore the factors associated with poor knowledge. Methods: A cross-sectional study was conducted among PCPs working at primary health-care centers in Jeddah, Saudi Arabia. A semi-structured questionnaire comprising 20 items related to CM diagnosis and treatment was used. Results: A total of 136 PCPs responded (aged 36.4 ± 8.1, 68.4% were females). The overall median (P75) knowledge score was 13.0 (15.0), and 45.6% of the participants had adequate knowledge (score > median). The majority of respondents (>50%) could not identify the lower limits of CM duration, the necessity of identifying at least eight migraine attacks in a month, the importance of managing medication overuse, and the indication of topiramate as the most efficacious agent in CM. Young physicians (23–35 years), bachelor graduates, general practitioners (GPs), and those having ≤5 years of experience scored lower than their peers. Physicians with 6–10 years of clinical experience were independently more knowledgeable than less-experienced PCPs (odds ratio = 5.09, P = 0.006). Conclusion: Knowledge regarding CM diagnosis and treatment was inadequate among PCPs, which could detrimentally influence the patterns of referral to secondary health-care facilities. Given these observations, it is recommended to amend the academic curricula for medical students/GPs and adopt continuing medical education programs for PHPs to support their levels of knowledge.

Background: Tension-type headache (TTH) is the most common primary headache disorder among medical students. It affects academic performance and the quality of the student's daily lives.Objective: This study aimed to investigate the prevalence of TTH and associated factors among students at King Abdulaziz University (KAU) in Jeddah, Saudi Arabia. Methods: A cross-sectional study involved students at KAU in the academic years from 4th to 6th grades during the calendar year of 2019. For sampling purposes, we adopted a stratified proportional random sampling technique, and for data collection, we used a selfadministered questionnaire. We defined TTH according to the diagnostic criteria in the third edition of the International Classification of Headache Disorders (ICHD-3b) from the International Headache Society (HIS). Results: A total of 387 medical students were approached, 50.1% were females, and 49.9% were males; their mean age was 22.8 ± SD 1.4. The lifetime TTH was 43.9%, and the 1-year prevalence TTH was 28.9%, these included both frequent TTH 25% and infrequent TTH 73%. Only 2% suffered from chronic TTH. Female sex was an unconfounded predictor for TTH, and sleeping for less than 8 hours/night was significantly associated with TTH (p<0.05). The most common aggravating factors included studying stressors (83.3%), and psychological stressors (46.5%). Conclusion: tension-type headache is a common problem among medical students. It is highly recommended to provide a stress-free study environment, stress management courses, and relaxation programs.