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Sabbagh HJ, AlSharif MT, Abdulhameed FD, Aljohar AJ, Alhussain RM, Alghamdi SM, Alrejaye NS, AlGudaibi LY, Sallout BI, Albaqawi BS, Alnamnakani EA, Brekeit LK, Basri OA, Almalik MI, Al Soqih NS, Alshaikh AB, Aburiziza AJ, Al Qahtani FA, Alghamdi BM, Alraddadi AK, Khaja HH, Alamoudi RA. Maternal Exposure to Stress During Covid-19 and Non-Syndromic Orofacial Clefts: A Cohort Retrospective Study. Cleft Palate Craniofac J 2024:10556656231224198. [PMID: 38239006 DOI: 10.1177/10556656231224198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2024] Open
Abstract
OBJECTIVE The coronavirus (COVID-19) pandemic presents an opportunity to study stress's effect on the development of non-syndromic orofacial clefts (NSOFCs). This study was aimed at assessing maternal stress exposure during the pregestational to first trimester pregnancy periods and the development of NSOFCs during a year of the COVID-19 pandemic. DESIGN Cohort study of infants with NSOFCs and controls matched based on recruitment site and age. SETTING Government hospitals in Saudi Arabia between November 2020 and November 2021. MAIN OUTCOME MEASURES Data collection included NSOFC clinical examination and maternal stress exposure assessment using the Modified Life Events Questionnaire, the Fear of COVID-19 Scale, and a focus on the lack of pregnancy planning and a threatened miscarriage. RESULTS Of the 557 infants recruited, 191 had NSOFCs. Logistic regression analysis with adjusted odds ratios (AORs) that removed the effects of confounders showed that any of the seven stressful life events (AOR:3.78, P < .001) and the family histories of relatives with NSOFCs (AOR:9.73, P < .001) increased the AOR for NSOFC development. In contrast, maternal folic acid (AOR:0.56, P.010), threatened miscarriage (AOR:0.17, P = .001), fear of COVID-19 (AOR:0.83, P = .038), and suspected COVID-19 infection (AOR:0.43, P = .008) decreased the AOR for NSOFC development. CONCLUSION Along with an established risk associated with family history of birth defects, stressful life events may be a risk factor for NSOFC development. Beyond folic acid's known benefit, it may be that higher maternal health concerns contribute to increased protective health behaviors during pregnancy. Ongoing research is needed to specify the maternal risk factors for NSOFC.
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Affiliation(s)
- Heba Jafar Sabbagh
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mona Talal AlSharif
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Fatma Dawood Abdulhameed
- Pediatric Surgery Department, King Salman Medical City, Maternity and Children's Hospital, Madinah, Saudi Arabia
| | - Aziza Johar Aljohar
- Consultant Pedodontist, Department of Dentistry, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Reema Mahdi Alhussain
- Pediatric Dentistry Department, Dammam Medical Complex, Eastern Province, Saudi Arabia
| | - Sultan Musaad Alghamdi
- Pediatric Dentistry Department, Bisha Dental Centre, Ministry of Health, Bisha, Saudi Arabia
| | - Najla Sulaiman Alrejaye
- Preventive Dental Science Department, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Latifa Yousef AlGudaibi
- Resident in the Saudi Board of Orthodontics and Dentofacial Orthopedics Program, King Abdulaziz Medical City, Ministry of National Guard Health Affairs; King Saud bin Abdulaziz University for Health Sciences, College of Dentistry; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Bahauddin Ibraheem Sallout
- Consultant in Obstetrics and Gynecology, Maternal Fetal Medicine, Women's Specialized Hospital, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Badi Shoaib Albaqawi
- Consultant, Maternal Fetal Medicine, Women's Specialized Hospital, King Fahad Medical City, Riyadh, Saudi Arabia
| | | | - Lougin Khalid Brekeit
- Orthodontic Resident, Orthodontics and Dentofacial Orthopedics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Osama Adel Basri
- Craniofacial Orthodontists, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia
| | - Manal Ibrahim Almalik
- Consultant Pedodontist, Dental Department, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Norah Suliman Al Soqih
- Department of Pediatrics, Qassim University, College of Medicine, Buraidah, Saudi Arabia
| | - Ali Bakr Alshaikh
- Resident in Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Faisal Ali Al Qahtani
- Pediatric Dentistry Department, Faculty of Dentistry, King Khalid University, Abha, Saudi Arabia
| | | | | | - Hadeel Hamza Khaja
- Center of Congenital Malformations in Fetuses and Newborns, King Salman bin Abdulaziz Medical City, Madinah, Saudi Arabia
| | - Rana Abdullah Alamoudi
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Saha I, Majumder J, Bagepally BS, Ray S, Saha A, Chakrabarti A. Burden of mental health disorders and synthesis of community-based mental health intervention measures among adolescents during COVID-19 pandemic in low middle-income countries: A systematic review and meta-analysis. Asian J Psychiatr 2023; 89:103790. [PMID: 37839154 DOI: 10.1016/j.ajp.2023.103790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/20/2023] [Accepted: 09/22/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND COVID-19 pandemic and the resultant lockdown could have negatively impacted adolescent mental health. The synthesised burden of mental health illness among adolescents during or after the pandemic is unknown in Low Middle-Income Countries (LMICs). The objective was to ascertain the pooled prevalence of mental health disorders among adolescents aged 10 - 19 years and to systematically review & conduct a descriptive synthesis of community-based mental health intervention measures in addressing adolescent mental health disorders during the COVID-19 pandemic in LMICs. METHODS The literature was searched in Embase, PubMed, and Scopus and selected the relevant studies. The data was extracted from the selected studies, and its quality was assessed using adapted Newcastle-Ottawa Quality Assessment Scales. Meta-analysis was performed using random effects model to pool the prevalence of mental health disorders. Statistical heterogeneity was evaluated through Cochran's Q test & I2 statistic. RESULTS Thirty-five studies were selected out of 7955 identified studies. Most of the studies (n = 7, each) were from India and Iran. The majority of research works were community-based (n = 18), conducted in 2020 (23 articles), and participant interviews were conducted through online mode (n = 21). Varied instruments were used to measure the burden of mental health in different settings. Pooled prevalence (95% confidence intervals) of anxiety, depression and stress was found to be 43.69 (18.58-68.80)%, 47.02 (31.72-62.32)% and 39.97 (30.53-49.40)%, respectively, with high heterogeneity between the studies. No studies reported community-based mental health interventions. CONCLUSION There has been a higher prevalence of anxiety, depression, stress, and other mental health illnesses, among adolescents in LMICs during the COVID-19 pandemic. It is important to note that no existing literature directly addresses community-based interventions for these common mental health illnesses. It is imperative to prepare the health system for early identification and management of common mental health illness among the adolescent age group in the event of any future disaster.
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Affiliation(s)
- Indranil Saha
- ICMR-Centre for Ageing & Mental Health, Salt Lake, Kolkata, India.
| | - Joydeep Majumder
- ICMR-Centre for Ageing & Mental Health, Salt Lake, Kolkata, India
| | | | - Sujoy Ray
- Southern Health NHS Foundation Trust, UK
| | - Asim Saha
- ICMR-Centre for Ageing & Mental Health, Salt Lake, Kolkata, India
| | - Amit Chakrabarti
- ICMR-Centre for Ageing & Mental Health, Salt Lake, Kolkata, India
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Agyapong B, Shalaby R, Hay K, Pattison R, Eboreime E, Korthuis M, Wei Y, Agyapong VIO. Exploring Sociodemographic Characteristics, Adverse Childhood Experience, and Mental Health History as Predictors of Anxiety and Depression among Adolescents and Young Adults: Findings from the MoreGoodDays Support Program in Alberta, Canada. Behav Sci (Basel) 2023; 13:749. [PMID: 37754027 PMCID: PMC10525571 DOI: 10.3390/bs13090749] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/03/2023] [Accepted: 09/05/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has increased psychological disorders among adolescents and young adults. METHODS This study used a cross-sectional design. An online survey questionnaire was used to collect sociodemographic and clinical information from subscribers of MoreGoodDays program, a daily supportive text message program co-designed with adolescents and young adults for their peers in Alberta. Validated instruments, the Generalized Anxiety Disorder GAD-7 scale and Patient Health Questionnaire-9 PHQ-9 were used to collect information on likely GAD and likely major depressive disorder (MDD). Data was analyzed with SPSS version 25 using chi-squared tests and binary logistic regression analysis. RESULTS 343 subscribers of MoreGoodDays participated in the survey. Overall, 117 (56.0%) respondents had a likely MDD and 97 (46.6%) had a likely GAD. Participants who would like to receive mental health counselling were 27 times more likely to experience GAD (OR = 27; 95% CI: 3.09-250.00) and 40 times more likely to experience MDD (OR = 40.03; 95% CI: 4.43-361.51) than those who did not. Respondents who had received mental health counselling in the past were 18.5 times more likely to experience MDD compared with those who had not (OR = 18.52; 95% CI: 1.55-200.00). Demographic variables, including age, education, employment, and relationship status, and clinical variables, such as history of anxiety, depression, obsessive-compulsive disorder, ADHD, and adverse childhood experience, did not independently the predict presence of likely GAD or MDD in subscribers of MoreGoodDays. CONCLUSION The prevalence of anxiety and depression was relatively high among subscribers of MoreGoodDays, indicating the long-term effect of the COVID-19 pandemic. This finding has significant implications in the broader contextof mental health research and emphasizes the need for more research into innovative mental health support for this cohort. The desire to receive counselling was predictive of both anxiety and depression and is a positive sign of the openness of this cohort to receive psychological intervention. Since this group is mostly adapted to mobile text technology, government agencies and policymakers should prioritize and implement readily accessible interventions such as supportive text messages to support their psychological well-being.
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Affiliation(s)
- Belinda Agyapong
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Reham Shalaby
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | | | | | - Ejemai Eboreime
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Mark Korthuis
- Glenrose Rehabilitation Hospital Foundation, Edmonton, AB T5G 0B7, Canada
| | - Yifeng Wei
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Vincent Israel Opoku Agyapong
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada
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Sabbagh HJ, Alamoudi RA, Zeinalddin M, Al Bulushi T, Al-Batayneh OB, AboulHassan MA, Koraitim M, Quritum M, Almuqbali B, Alghamdi SM, Refahee SM, Alkharafi L, Taqi FF, Albassam B, Ayed M, Embaireeg A, Alnahdi R, AlSharif MT, Abdulhameed FD, Aljohar AJ, Alrejaye NS, Almalik MI, Viswapurna PS, Al Halasa T, El Tantawi M. COVID-19 related risk factors and their association with non-syndromic orofacial clefts in five Arab countries: a case-control study. BMC Oral Health 2023; 23:246. [PMID: 37118740 PMCID: PMC10141804 DOI: 10.1186/s12903-023-02934-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 04/03/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND The environmental etiology of non-syndromic orofacial clefts (NSOFCs) is still under research. The aim of this case-control study is to assess COVID-19 associated factors that may be related to the risk of NSOFC in five Arab countries. These factors include COVID-19 infection, COVID-19 symptoms, family member or friends infected with COVID-19, stress, smoking, socioeconomic status and fear of COVID-19. METHODS The study took place in governmental hospitals in five Arab countries from November 2020 to November 2021. Controls are matched in the month of delivery and site of recruitment. A clinical examination was carried out using LASHAL classification. Maternal exposure to medication, illnesses, supplementation, COVID-19 infection during their pregestation and 1st trimester periods were evaluated using a validated questionnaire. Maternal exposure to stress was assessed using the Life Events scale, fear of covid-19 scale, family member or friend affected with covid-19 infection, pregnancy planning and threatened abortion. RESULTS The study recruited 1135 infants (386 NSOFC and 749 controls). Living in urban areas, maternal exposure to medications 3-months pregestation, maternal exposure to any of the prenatal life events and maternal fear of COVID-19 significantly increased the risk of having a child with NSOFC. On the other hand, mothers exposed to supplementation 3-months pregestation, mothers suspected of having COVID-19 infection, family members or friends testing positive with COVID-19 significantly decreased the risk of having a child with NSOFC. CONCLUSIONS This study suggests that NSOFC may be associated with maternal exposure to lifetime stress and COVID-19 fear in particular, with no direct effect of the COVID-19 infection itself. This highlights the importance of providing psychological support for expecting mothers during stressful events that affect populations such as the COVID-19 pandemic, in addition to the usual antenatal care.
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Affiliation(s)
- Heba Jafar Sabbagh
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Rana A Alamoudi
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | | | | | - Ola B Al-Batayneh
- Preventive Dentistry Department, Jordan University of Science & Technology, Irbid, 22110, Jordan
| | | | - Mohamed Koraitim
- Maxillofacial and Plastic Surgery Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Maryam Quritum
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, 21527, Egypt
| | | | | | | | | | | | - Bader Albassam
- Department of General Dentistry, Ministry of Health, Kuwait, Kuwait
| | - Mariam Ayed
- Neonatal Department, Maternity Hospital-Kuwait, Kuwait, Kuwait
| | - Alia Embaireeg
- Neonatal Department, Maternity Hospital-Kuwait, Kuwait, Kuwait
| | | | - Mona Talal AlSharif
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Fatma Dawood Abdulhameed
- Pediatric Surgery Department, King Salman Medical City, Maternity and Children's Hospital, Madinah, Saudi Arabia
| | - Aziza Johar Aljohar
- Department of Dentistry, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Najla Sulaiman Alrejaye
- Department of Dentistry, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | | | | | - Tamara Al Halasa
- Preventive Dentistry Department, Jordan University of Science & Technology, Irbid, 22110, Jordan
| | - Maha El Tantawi
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, 21527, Egypt.
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Alamoudi RA, Al-Jabri BA, Alsulami MA, Sabbagh HJ. Prenatal maternal stress and the severity of autism spectrum disorder: A cross-sectional study. Dev Psychobiol 2023; 65:e22369. [PMID: 36811367 DOI: 10.1002/dev.22369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 12/08/2022] [Accepted: 01/04/2023] [Indexed: 02/10/2023]
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder linked to several genetic and environmental factors including antenatal stress. Hence, we aimed to examine whether a mother's stress during pregnancy is associated with the severity of autism spectrum disorder in children. The study was conducted with 459 mothers of children with autism (aged 2-14 years) who were attending rehabilitation and educational centers in the two major cities of Makkah and Jeddah in Saudi Arabia. Environmental factors, consanguinity, and ASD family history were assessed using a validated questionnaire. The Prenatal Life Events Scale questionnaire was used to assess whether the mothers were exposed to stress during pregnancy. Two models of ordinal regression analysis were conducted including gender, child age maternal age, parental age, maternal education, parental education, income nicotine exposure, mother taking medication during pregnancy, family history of ASD, gestation, consanguinity, exposure of prenatal life events (in model 1), and severity of prenatal life events (in model 2). Family history of ASD showed a statistically significant association with the severity of ASD in both regression models (p = .015, odds ratio [OR]: 4.261 in Model 1, and p = .014, OR: 4.901 in model 2). In model 2, the moderate severity prenatal life events showed higher statistically significant adjusted odds ratio for ASD severity compared to no stress (p = .031; OR: 3.82). Within the limitations of this study, prenatal stressors showed some potential contribution to ASD severity. Family history of ASD was the only factor that showed a persistent association with ASD severity. A study that assesses the effect of COVID-19 stress on ASD prevalence and severity is recommended.
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Affiliation(s)
- Rana A Alamoudi
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Basma A Al-Jabri
- Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Heba Jafar Sabbagh
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Sabbagh HJ, Abdelaziz W, Quritum M, Alamoudi RA, AlKhateeb NAB, Abourdan J, Qureshi N, Qureshi S, Hamoud AHN, Mahmoud N, Odeh R, Al-Khanati NM, Jaber R, Balkhoyor AL, Shabi M, Folayan MO, Alade O, Gomaa N, Alnahdi R, Mahmoud NA, El Wazziki H, Alnaas M, Samodien B, Mahmoud RA, Assab NA, Saad S, Alsayad MM, Alhachim SG, El Tantawi M. A multi-country study on the impact of sex and age on oral features of COVID-19 infection in adolescents and young adults. BMC Oral Health 2022; 22:513. [PMID: 36402969 PMCID: PMC9675238 DOI: 10.1186/s12903-022-02515-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 10/18/2022] [Indexed: 11/21/2022] Open
Abstract
Background Oral diseases are features of COVID-19 infection. There is, however, little known about oral diseases associated with COVID-19 in adolescents and young adults (AYA). Therefore, the aim of this study was to assess oral lesions’ association with COVID-19 infection in AYA; and to identify if sex and age will modify these associations. Methodology Data was collected for this cross-sectional study between August 2020 and January 2021 from 11-to-23 years old participants in 43-countries using an electronic validated questionnaire developed in five languages. Data collected included information on the dependent variables (the presence of oral conditions- gingival inflammation, dry mouth, change in taste and oral ulcers), independent variable (COVID-19 infection) and confounders (age, sex, history of medical problems and parents’ educational level). Multilevel binary logistic regression was used for analysis. Results Complete data were available for 7164 AYA, with 7.5% reporting a history of COVID-19 infection. A significantly higher percentage of participants with a history of COVID-19 infection than those without COVID-19 infection reported having dry mouth (10.6% vs 7.3%, AOR = 1.31) and taste changes (11.1% vs 2.7%, AOR = 4.11). There was a significant effect modification in the association between COVID-19 infection and the presence of dry mouth and change in taste by age and sex (P = 0.02 and < 0.001). Conclusion COVID-19 infection was associated with dry mouth and change in taste among AYA and the strength of this association differed by age and sex. These oral conditions may help serve as an index for suspicion of COVID-19 infection in AYA. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02515-5.
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Affiliation(s)
- Heba Jafar Sabbagh
- grid.412125.10000 0001 0619 1117Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, P.O. Box: 80200, Jeddah, 21589 Saudi Arabia
| | - Wafaa Abdelaziz
- grid.7155.60000 0001 2260 6941Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, 21561 Egypt
| | - Maryam Quritum
- grid.7155.60000 0001 2260 6941Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, 21561 Egypt
| | - Rana Abdullah Alamoudi
- grid.412125.10000 0001 0619 1117Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, 21589 Saudi Arabia
| | - Nada Abu Bakr AlKhateeb
- grid.412125.10000 0001 0619 1117Faculty of Medicine, King Abdulaziz University, Jeddah, 21589 Saudi Arabia
| | - Joud Abourdan
- grid.411781.a0000 0004 0471 9346Medical Faculty, Istanbul Medipol University, 34230 Istanbul, Turkey
| | - Nafeesa Qureshi
- City Quay Dental Practice and Implant Centre, Dundee, DD1 3JA UK
| | - Shabnum Qureshi
- grid.412997.00000 0001 2294 5433Department of Education, University of Kashmir, Srinagar, 190006 India
| | - Ahmed H. N. Hamoud
- grid.7155.60000 0001 2260 6941Faculty of Dentistry, Alexandria University, Alexandria, 21561 Egypt
| | - Nada Mahmoud
- grid.449328.00000 0000 8955 8908Faculty of Dentistry, National Ribat University, 1111 Khartoum, Sudan
| | - Ruba Odeh
- grid.444470.70000 0000 8672 9927College of Dentistry, Ajman University, Ajman, United Arab Emirates
| | - Nuraldeen Maher Al-Khanati
- grid.449576.d0000 0004 5895 8692Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Syrian Private University, Damascus, 386 Syria
| | - Rawiah Jaber
- grid.412125.10000 0001 0619 1117General Courses, King Abdulaziz University, Jeddah, 21589 Saudi Arabia
| | - Abdulrahman Loaie Balkhoyor
- grid.412125.10000 0001 0619 1117Faculty of Engineering, King Abdulaziz University, Jeddah, 21589 Saudi Arabia
| | - Mohammed Shabi
- grid.460099.2University of Jeddah, Jeddah, 23218 Saudi Arabia
| | - Morenike Oluwatoyin Folayan
- grid.10824.3f0000 0001 2183 9444Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Osun State Nigeria
| | - Omolola Alade
- grid.10824.3f0000 0001 2183 9444Department of Preventive and Community Dentistry, Faculty of Dentistry, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Noha Gomaa
- grid.39381.300000 0004 1936 8884Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario Canada
| | - Raqiya Alnahdi
- Department of Dental Surgery, Oman Dental College, 116 Muscat, Oman
| | - Nawal A. Mahmoud
- grid.444472.50000 0004 1756 3061Institute of Creative Art and Design (ICAD), Kuala Lumpur Campus, UCSI University, 56000 Kuala Lumpur, Malaysia
| | - Hanane El Wazziki
- Department of Cereal Plant Pathology, National Institute of Agricultural Research, 10090 Rabat, Morocco
| | - Manal Alnaas
- grid.8241.f0000 0004 0397 2876Division of Imaging Science and Technology, School of Medicine, University of Dundee, Dundee, DD1 4HN UK
| | - Bahia Samodien
- Western Cape Education Department, Cape Town, 8001 South Africa
| | - Rawa A. Mahmoud
- Musculoskeletal Center, International Medical Centre, Jeddah, 21451 Saudi Arabia
| | - Nour Abu Assab
- Schools of Awqaf, Directorate of Education, Jerusalem, Israel
| | - Sherin Saad
- grid.8761.80000 0000 9919 9582Department of Pharmacology, Institute of Neuroscience and Physiology, University of Gothenburg, Box 431, 40530 Gothenburg, Sweden
| | | | | | - Maha El Tantawi
- grid.7155.60000 0001 2260 6941Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, 21561 Egypt
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