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Perception of Saudi undergraduate medical students on telemedicine training and its implementation
(2023) El Kheir, Dalia Y. M.; AlMasmoom, Nour S.; Eskander, Mariam K.; Alshamrani, Reem A.; Alwohaibi, Rawaa N.; AlTheeb, Fatimah N.; Aleid, Bedour A.
BACKGROUND: The use of telemedicine has increased considerably in healthcare delivery, especially during this time of the coronavirus disease 2019 (COVID-19) pandemic. It has, therefore, become necessary to train medical students to better equip them for this new means of healthcare delivery. The aim of the present study was to assess the perception of undergraduate medical students on telemedicine training. MATERIALS AND METHODS: A cross-sectional study was conducted on a total of 521 undergraduate medical students studying in the Eastern Region of Saudi Arabia. Data were collected via a self-administered pretested questionnaire comprising two main sections: demographics and knowledge and opinions regarding telemedicine training. RESULTS: About 73% students think that the use of telemedicine for patient care will increase in the future, and 59.3% think that the medical students should be trained in telemedicine. Majority of the students (78%) opined that telemedicine training should be optional and 58% said it should be taught during the clinical phase of the undergraduate curriculum. The best telemedicine training course learning objectives medical students opined to be included were: telemedicine practical skills (70.2%), legal aspects of telemedicine practice (68.3%), and potential positive and/or negative use of telemedicine tools and methods (67.6%). Telemedicine skills students would like to learn how to effectively engage patients, knowledge about telemedicine regulations and the consequences of breaching them. CONCLUSION: Medical students are aware of the importance of incorporating telemedicine training into the medical curriculum. Training these students is vital to ensure their competence as physicians in their future clinical careers, that is make them a digitally health-literate future workforce.
Association between diabetes-related distress and glycemic control in primary care patients with Type 2 diabetes during the coronavirus disease 2019 (COVID-19) pandemic in Egypt
(2023) Elotla, Sally F.; Fouad, Ahmed M.; Mohamed, Samar F.; Joudeh, Anwar I.; Mostafa, Mona; Hayek, Samer El; Shah, Jaffer; Ahmed, Hazem A. S.
Abstract: BACKGROUND: Diabetes-related distress and glycemic control are of a particular concern to primary care physicians because of the impact of the coronavirus disease 2019 pandemic on diabetic patients’ lifestyle, psychological well-being and healthcare access. Our aim was to evaluate the relationship between diabetes-related distress and glycemic control in diabetic patients with Type 2 diabetes mellitus (T2DM) in primary care settings during the pandemic. MATERIALS AND METHODS: This cross-sectional study was conducted at primary healthcare clinics in a rural area in Egypt among 430 patients with T2DM during the period from September 2020 to June 2021. All patients were interviewed for their sociodemographic, lifestyle, and clinical characteristics. Diabetes-related distress was measured by the problem areas in the diabetes scale (PAID), where a total score of ≥40 indicated a severe diabetes-related distress. The most recent glycosylated hemoglobin (HbA1c) measurements were used to indicate the glycemic control. Quantile regression model (0.50 quantile) was used to perform the multivariate analysis to identify significant factors associated with HbA1c level. RESULTS: Most of the participants had a suboptimal glycemic control (92.3%), while 13.3% had severe diabetes-related distress. HbA1c level was significantly and positively correlated with the total PAID score and all its sub-domains. Multivariate quantile regression revealed that obesity, multi-morbidity, and severe diabetes-related distress were the only significant determinants of the HbA1c median level. Obese patients had significantly higher median HbA1c compared to patients who were not obese (coefficient = 0.25, P < 0.001). Patients with two or more comorbidities (i.e., multimorbidity) had a significantly higher median HbA1c than patients with single or no chronic comorbidities (coefficient = 0.41, P < 0.001). Severe diabetes-related distress was significantly associated with higher median HbA1c compared to nonsevere diabetes-related distress (coefficient = 0.20, P = 0.018). CONCLUSION: Diabetes-related distress had a significant association with HbA1c level. Family physicians should implement multifaceted programs to optimize diabetes control and reduce any associated distress.
Effect of concept mapping model on critical thinking skills of family medicine residents: A randomized controlled trial
(2023) Mahmoud, Mervat M.S.; Shokry, Dina A.; Mowafy, Maha A.E.; Elden, Nesreen M.K.; Hasan, Marwa D.A.
BACKGROUND: The cognitive process of critical thinking (CT) involves the examination of the existing reasons and an analysis of the information to draw conclusions and make decisions. The goal of the study was to determine how concept mapping (CM) technique affects family medicine residents’ capacity for critical thought. MATERIALS AND METHODS: We conducted a randomized controlled trial among family medicine residents aged between 26 and 28 years. A total of 100 residents were involved; over the course of 3 months, 50 residents were exposed to the conventional teaching model and 50 residents to the CM model. Data was collected using California CT skills test (CCTST) modified Arabic version and a self-administered questionnaire. The primary intervention was teaching method, experimental group received CM lessons while control group had conventional lessons. First session was carried out at baseline and second session one week after baseline, whereas 3rd, 4th, and 5th sessions conducted at end of 1st, 2nd, 3rd months, respectively. Both groups were assessed at baseline and at end of 3rd month. Both groups were reassessed at end of three months. Quantitative data was presented as mean and SD, whereas frequencies and percentages used for qualitative data. Pre- and post-intervention CT scores for study groups were compared using t-test or Mann-Whitney U test, as appropriate. Groups were compared on pre- and post-intervention CT grades using Chi-square test. RESULTS: Vast majority (98%) of participants were females, nearly half were 27 year old, and belonged primarily to urban areas (76%). There was no difference in the CT scores between the groups at baseline. The post-intervention CT scores for study group were statistically significantly higher (18.36±2.68) compared to control group (15.94±1.94) (P = 0.001). CONCLUSION: The CM approach was superior to the conventional teaching approach in terms of improving CT.
Distant learning and primary school teacher burnout: Assessing the effect during coronavirus disease (COVID-19) in Jeddah, Saudi Arabia, 2021
(2023) Altwaim, Najlaa M.; Kadi, Mai S.; Alfakeh, Solhi A.
BACKGROUND: Teaching is indeed a very stressful occupation. Owing to the novel coronavirus SARS-CoV-2, certain changes were made in education in Saudi Arabia. A switch to a 100% distant learning in some courses was implemented, thereby increasing the burden on teachers. The aim of this study was to assess the level of burnout and the impact of distant learning on burnout in primary school teachers during the pandemic. MATERIALS AND METHODS: This cross-sectional study recruited 295 primary school teachers in Jeddah City, Saudi Arabia. Data were collected using self-administered questionnaire having two parts: the first part included questions on sociodemographic charecteristics and the second part included questions related to distant learning and the Arabic version of the Maslach Burnout Inventory. Chi-square test was used to assess association between burnout and various factors. For comparison of mean scores by various factors, analysis of variance (ANOVA) was performed. RESULTS: A high level of burnout was perceived by 48.4% of the teachers in the dimension of emotional exhaustion, 26.4% in the depersonalization dimension, and 60% in the reduced personal accomplishment dimension. Teachers in the public school showed a higher burnout score than teachers in the private schools. The teachers in 40–50 age group had higher scores than the teachers with other age groups. There were no significant differences in terms of gender and years of experience. A higher proportion of teachers working in private schools had higher personal accomplishment than teachers working in Government schools (P = 0.01). Regarding personal accomplishment and depersonalization subscales, there were differences between the different types of schools. The teachers who believed “distance/E-learning was difficult” had lower personal accomplishment score. CONCLUSION: According to the study, primary teachers in Jeddah suffer from burnout. More programs should be implemented to deal with teacher burnout and more research focusing on these groups should be done.
Adjustment disorder among first year medical students at King Saud University, Riyadh, Saudi Arabia, in 2020
(2023) Alhussain, Fahad A.; Onayq, Abdulhakim I. Bin; Ismail, Dawood H.; Alduayj, Mohammed A.; Alawbathani, Turki A.; Aljaffer, Mohammed A.
Abstract: BACKGROUND: The general health and well-being of medical students has become a matter of concern, as medical students have higher levels of stress than their nonmedical peers. Long-standing stress may lead to serious outcomes, such as depression, anxiety, poor quality of life, or adjustment disorders. This study aimed to estimate the proportion of first year medical students who have adjustment disorder and explore possible risk factors. MATERIALS AND METHODS: This cross-sectional study was conducted among all first-year medical students at King Saud University, College of Medicine, Saudi Arabia. The adjustment disorder-new model 20 (ADNM-20) was used to assess adjustment disorder with the stressor and item lists. The item list scores were summed and a cutoff point >47.5 was designated as a high risk of developing the disorder. Descriptive analysis included computing mean and standard deviation for continuous variable while frequency and percentages for categorical variables. Chi-square test and logistic regression analysis determined risk factors for having an adjustment disorder and the stress of attending a medical school. RESULTS: The study enrolled 267 students but only 128 completed the ADNM-20 survey. Out of 267 students, the most commonly reported recent stressor was too much/too little work, and 52.8% reported having difficulty in meeting deadlines. The most common core symptom expressed by the medical students was avoidance behavior with a mean score of 10.91 ± 3.12, followed by preoccupation with stressors with a mean score of 10.66 ± 3.10. The factors significantly associated with having adjustment disorder were being female, younger age, recent illness of a loved one, having family conflicts, and having too much or too little work. CONCLUSION: First year medical students are at increased risk of adjustment disorder. Screening and awareness programs may be considered for preventing adjustment disorder. Increased student-staff interactions may provide support to adapt to their new environment and help reduce social adjustment difficulties.
Determinants of periodic health examination uptake among adults in Al-Jouf Region, Saudi Arabia
(2023) Alzahrani, Ali M.; Felix, Holly C.; Al-Etesh, Nashmi S.
BACKGROUND: Periodic Health Examinations (PHEs) typically occur annually and provide an important opportunity for providers to screen their patients for undiagnosed health conditions and monitor existing conditions, such as diabetes and hypertension. Unfortunately, PHEs are reported to be low in Saudi Arabia. This study’s aim was to assess the regular uptake of PHEs by adults residing in Al-Jouf region, Saudi Arabia. MATERIALS AND METHODS: A cross-sectional survey was conducted among adults (aged ≥ 20 years) residing in five communities in the Al-Jouf Region on sociodemographic characteristics, self-reported chronic conditions, knowledge of PHEs, and their regular uptake. Chi-square tests and multivariate logistic regression analysis were performed to determine the factors associated with regular uptake of PHEs. RESULTS: A total of 624 participants completed the survey questionnaire. Of the participants, 27.7% reported a regular uptake of PHEs. The odds of regular uptake of PHEs were higher among older respondents (odds ratio [OR] =1.98; P = 0.002), those who reported that they had diabetes (OR = 3.25; P < 0.001), hypertension (OR = 4.11; P = 0.001), hyperlipidemia (OR = 2.66; P = 0.003), and those with a higher PHEs knowledge score (OR = 1.35; P < 0.001). However, the odds regular uptake of PHEs among respondents residing in the three governorates and Skaka city were significantly lower (OR = 0.27; P = 0.001 and OR = 0.30; P = 0.002, respectively) than their counterparts. CONCLUSION: Low rates of PHEs uptake were observed among the survey participants in the Al-Jouf Region of Saudi Arabia. The characteristics of individuals associated with low uptake of PHEs were identified. Tailored interventions, such as the use of community health workers and clinic communications, could target these individuals to increase the uptake of PHEs.
Spinal cord compression secondary to intraspinal extramedullary hematopoiesis
(2023) AlShamrani, Foziah J.; AlMohish, Noor M.; AlDawsari, Fahad A.; AlObaid, Jaafer J.; AlGhanimi, Ibrahim A.; AlNahdi, Abdullah A.
Extramedullary hematopoiesis (EMH) is a rare cause of spinal cord compression (SCC) occurring in various hematological illnesses such as myeloproliferative disorders, thalassemias, and various types of anemia. EMH represents the growth of blood cells outside the bone marrow. Common EMH locations include the spleen, liver, lymph nodes, and paravertebral regions. When this occurs in the spinal cord, the mass effect can compress the spinal cord and cause different neurological symptoms depending on the area of the spinal cord affected. This report describes a 27-year-old female with a known case of beta-thalassemia major, who presented with mid-thoracic back pain, weakness, and paresthesia at the T10 level. In addition, this report illustrates the importance of considering EMH in the differential diagnosis of SCC in patients with thalassemia.
The degree of nicotine dependence among users of different tobacco and nicotine products in Madinah City, Saudi Arabia
(2023) Almutairi, Rami M.; Al-Dubai, Sami A. R.; Almutairi, Mai M.; Alharbi, Hani H.; Alshlahi, Hatim M.; Albadrani, Muayad S.
Abstract: BACKGROUND: Nicotine addiction has many consequences. The World Health Organization has classified nicotine dependence as a disorder of substance use. This study aimed to assess the dependence in users of different tobacco and/or nicotine-containing products (TNPs). MATERIALS AND METHODS: This analytical, cross-sectional study involved 211 TNP users in Madinah, Saudi Arabia. The data was collected using a self-administered questionnaire that consisted of two main sections. The first section included sociodemographic domain, TNP status domain, and the Stages of Change model domain. The second section of the instrument included the ABOUT dependence construct comprising 12 items. Independent t-test, analysis of variance, and correlation analysis were used to assess the relationship between the study variables. RESULTS: Most users of TNPs exclusively used tobacco cigarettes (53.1%). Total dependence score was significantly associated with gender, marital status, age group, monthly income, nicotine concentration in electronic cigarettes (e-cigarettes) liquid, and the number of cigarettes smoked per day (P < 0.05). Total dependence score was correlated with the duration of TNP usage (r = 0.24, P < 0.001), Switching attempts to another TNP (r = 0.16, P = 0.020), attempts of quitting TNPs (r = 0.25, P < 0.001), and willingness to quit (r = −0.37, P < 0.001). CONCLUSION: Dependence was associated with gender, marital status, age group, monthly income, nicotine concentration in e-cigarette liquid, and the number of cigarettes smoked per day. It was also associated with duration of TNP usage, Switching attempts to another TNP, attempts of quitting TNPs and the willingness to quit.
Effectiveness of the use of clickers versus group discussion in learning by undergraduate medical students
(2023) Iti, Jannatbi L.; Kadeangadi, Deepti M.
BACKGROUND: The evolution of Medical learning shows the incorporation of modern technology in teaching, learning, assessment, and medical practice. Clickers are easy to use, and provide instantaneous feedback on the student’s comprehension of the information given. The aim of the study was to assess the effectiveness of clickers in undergraduate medical students’ learning by comparing clickers’ scores with group discussion scores. MATERIALS AND METHODS: A cross-sectional comparative study with cross-over design was conducted for 6 months on 80 students of Phase III Part I MBBS. After an interactive lecture on diarrhea with a community medicine perspective, the students were divided into two groups, A and B, each consisting of 40 students. Group B students were further divided into five subgroups of eight students each. Group A students were assessed with clickers, Group B with group discussion and the cross-over done after 2 weeks. A questionnaire was used to assess the perceptions of the students on the use of clickers. Academic performance scores of the students were compared within the groups at different times (i.e. immediately after the interactive lecture and after 1st week and 2nd weeks) and between the two main groups. Data analysis was performed using SPSS. Mean and standard deviations were calculated for quantitative variables, whereas categorical data was presented as frequencies and proportions. Qualitative data was analyzed using content analysis technique. RESULTS: The mean age of students was 20.4 (SD=0.6) years. The mean scores for the students using clickers were significantly higher than the mean scores for the students using group discussion. Most of the students (78.8%) either agreed or strongly agreed that the “clickers were easy to use.” CONCLUSION: The study concluded that the academic performance of medical undergraduate students using clickers was better than the performance of the students using group discussions.
Prevalence of long-lasting loss of smell and taste after coronavirus disease 2019 infection in Saudi Arabia
(2023) Allhaiby, Nada M.; Allihybi, Sultan M.; Almhmadi, Amir H.; Alkot, Mohammad M.
BACKGROUND: People with coronavirus disease 2019 (COVID-19) who experience symptoms for more than 35 weeks are said to have long COVID. Anosmia can occur on its own or in combination with other COVID-19 symptoms. Anosmia may be a significant differential presentation for the suspicion and diagnosis of COVID-19 in patients with asymptomatic-to-mild COVID-19 disease and may disappear in 3 weeks. This study sought to determine the prevalence of persistent loss of taste and smell following COVID-19 in Saudi Arabia. MATERIALS AND METHODS: A population-based cross-sectional study was conducted among Saudi citizens who had been diagnosed with COVID-19 for more than 2 weeks and had experienced a loss of taste and smell. Data was collected using a questionnaire having questions about demographics, long-lasting loss of taste and smell, whether this related to COVID-19 infection, and whether respondents had received the COVID-19 vaccine. SPSS was used for data analysis; statistical significance was determined using Chi-square test. RESULTS: A total of 383 Saudis who had a history of COVID-19 participated in the study. About 43.3% study participants had experienced persistent loss of taste and smell after COVID-19 infection. A significant association was found between loss of smell and the region, Northern region having highest proportion of study participants who had loss of smell and Western region having the lowest prevalence (34%). CONCLUSION: There were permanent changes in the sense of taste or smell in 34.3% of participants. This might add to the growing weight of long COVID.
Frequency and risk factors for headache disability: A population-based cross-sectional study in Egypt
(2023) Elsary, Asmaa Y.; El-Sherbiny, Naglaa A.; Eldessouki, Randa
BACKGROUND: A headache is a very common condition that can have a significant impact on one’s quality of life. It is one of the leading causes of years lived with disability worldwide. The objective of the study was to determine the prevalence of primary headache disability, its characteristics, risk factors and its impact on daily life. MATERIALS AND METHODS: A cross-sectional study was conducted in Fayoum governorate. The sample size was 1909 participants. A multistage random sample technique was used to select adults aged above 18 years. A self-structured questionnaire solicited information on sociodemographic characteristics, headache characteristics, and the headache disability index. SPSS v 22.0 was used for data analysis. RESULTS: Headaches caused complete disability in 19.5% of the study group, and 76.8% developed severe disability. Participants who reported that they had a headache more than once a week were; 44.5% had moderate pain and 40.2% had more intense pain. About 55% complained of attacks rather than continuous headache and were more likely to have a degree of complete disability, (P = 0.001). A statistically significant association was found between living in urban areas, working in professional occupations, complaining of severe headache in the form of an attack and seeking medical advice, with high scores of headache disability. CONCLUSION: Headache is a condition that affects the entire population in a way that causes high levels of disability. Good management is necessary for the reduction of the adverse effects of headaches on the health of the population. This should focus on raising public awareness by means of education and on the provision of basic healthcare.
Association between fitness tracker use, physical activity, and general health of adolescents in Eastern Province of Saudi Arabia
(2023) AlSayegh, Layla A.; Al-Mustafa, Maria S.; Alali, Ali H.; Farhan, Manal F.; AlShamlan, Nouf A.; AlOmar, Reem S.
BACKGROUND: Physical inactivity is a major problem of adolescents worldwide. Fitness trackers are widely used technologies that assess physical activity and allow self-monitoring of daily activities. Thirty-five percent of the Saudi population is made up of adolescents, which makes them an important target population. Few studies have evaluated the association of fitness trackers with physical activity levels of adolescents. This study aimed to evaluate physical activity among adolescents and its relationship to their use of fitness trackers and overall health. MATERIALS AND METHODS: A cross-sectional study was carried out among adolescents in middle and high schools in the Eastern Province. Data was collected using a structured questionnaire and physical activity was assessed using International Physical Activity Questionnaire for Adolescents. Chi-square test and ANOVA were performed to test for statistical significance. Unadjusted and adjusted odds ratios (ORs) were obtained through ordered logistic regression models. Model diagnostics were run as post hoc analyses. RESULTS: Majority of participants (82.6%) had low physical activity levels, 12.2% had moderate and 5.2% had vigorous activity level. The model revealed that as participants’ ages increased, the odds of having higher levels of physical activity decreased (OR = 0.92; 95% confidence interval [CI]: 0.85–0.99). Moreover, participants who did not go to a gym regularly or own a fitness tracker were less likely to have higher physical activity levels (OR = 0.43; 95% CI:0.30–0.61, and OR = 0.44; 95% CI: 0.33–0.59, respectively). Motivation for using fitness trackers was mostly “no specific reason” for females. However, “luxury and esthetics” were mostly reported by males. CONCLUSION: Physical activity tends to be higher in younger adolescents who use fitness trackers, or go to the gym regularly, with no significant difference between males and females. However, the motivation behind adolescents’ use of fitness trackers varied by gender.
The effectiveness of self-empowerment-based patient-centered care for obese students in primary services: A randomized controlled trial
(2023) Dewi, Dian K.; Sekartini, Rini; Sunardi, Diana; Soewondo, Pradana; Yunir, Em; Widyahening, Indah S.; Asih, Sali R.; Seman, Anitawati; Latuasan, Kitra; Vidiawati, Dhanasari
Abstract: BACKGROUND: Self-empowerment-based patient-centered services with a coaching approach are imperative in the management of students with obesity. This study evaluated the applicability and effectiveness of self-empowerment-based patient-centered coaching for the weight loss program model for obese students. MATERIALS AND METHODS: This randomized control trial recruited 60 obese students aged 17–22 years in Universitas Indonesia from August to December 2021. Intervention group subjects were coached by a health coach. Each health coach assisted four subjects with SMART model coaching in six meetings every 2 weeks through a zoom platform. Both groups had instructions on obesity, nutrition, and physical activity from specialist doctors online. Paired t-test or Mann-Whitney test, as appropriate, to compare the measurements of anthropometry, body composition (bioelectrical impedance analysis), food intake (food record form), physical activity (physical activity form), subjective well-being (subjective well-being questionnaire), and healthy behavior habits (satisfaction scale) between the two groups before and after the intervention. RESULTS: A total of 41 obese students completed the study, 23 from intervention group and 18 from the control group. The change in total body fat (−0.9 [−12.9, 0.70] vs. 0.0 [−6.9, 3.50], P = 0.02) and healthy behavior habit (13.5 ± 11.85 vs. 7.5 ± 8.08, P = 0.04) in the intervention group was significantly greater than in the control group. The change in satisfaction scale of hobby/passion (2 [−4.6] vs. 1 [−2.2], P = 0.02), movement exercise (2.3 ± 2.11 vs. 1.2 ± 1.93, P = 0.03), sleep rest (2 [−6.5] vs. 1 [−3.2], P = 0.01), and spiritual (1 [0.6] vs. 0 [−1.3], P = 0.00) was significantly higher in the coached group. CONCLUSION: A weight loss program for obese students was tested through self-empowerment-based patient-centered care with a coaching approach and has proven to effect changes in anthropometric indicators, body composition, self-empowerment, food intake, and physical activity.
Prevalence and characteristics of obesity in patients with type-2 diabetes mellitus in primary care centers in Bahrain: A cross-sectional study
(2023) Alawainati, Mahmood A.; Ayoob, Zahra A.; AlQari, Aala A.; Makhlooq, Fatema; Naser, Huda S.; Bukamal, Fajer
BACKGROUND: Obesity is a complex health problem characterized by abnormal and excessive body weight. Globally, the epidemic of obesity is escalating, and today, around one-third of the world’s adult population is overweight or obese. Obesity is a risk factor and a predictor of poor outcomes of diabetes. This study aimed to determine the prevalence and characteristics of obesity in adults with type-2 diabetes mellitus. MATERIALS AND METHODS: This study was conducted at five primary care centers in Bahrain. Obesity was assessed using body mass index, while glycemic control status was assessed using glycated hemoglobin (HbA1c). Informed consent was obtained from all participants. Means and standard deviation were computed for continuous variables, while categorical variables were presented as frequencies and percentages. Student’s t-test and Mann-WhitneyU test, as appropriate, were performed to determine statistical significance between two continuous variables. Chi-square or Fisher’s Exact test were used to test for statistical significance for categorical variables. RESULTS: A total of 732 participants were included; the mean age was 58.4 ± 11.3 years. Hypertension was the most prevalent comorbidity (63.5%), followed by hyperlipidemia (51.9%). Most participants (59.8%) had HbA1c levels of more than 7%, 20.9% had HbA1c levels between 7% and 8%, and 38.9% had HbA1c levels of more than 8%. Of the cohort, 47.5% were obese and 35.0% were overweight. Obesity was significantly higher in Bahraini patients and females (P < 0.001). Lower obesity rates were observed among patients who exercised regularly (P < 0.001) and patients who followed diet control measures (P = 0.039). In addition, we found higher obesity rates were found in patients with uncontrolled diabetes (P = 0.004), hypertension (P = 0.032), and hyperlipidemia (P = 0.048). CONCLUSION: Obesity is prevalent among type-2 diabetic patients and is associated with poor glycemic outcomes. Thus, more efforts should be taken by physicians to address obesity in diabetic patients as it negatively impacts their glycemic control.
Atypical site of nasopharyngeal branchial cleft cyst: A case of an unusual age presentation
(2023) Alsharhan, Salma S.; Alghuneem, Aishah A.; Alrusayyis, Danah F.; Aljahli, Marwah S.
Nasopharyngeal branchial cleft cysts (NBC) are generally single, unilateral, and asymptomatic. They may get infected or produce obstructive symptoms as it enlarges. The definitive diagnosis is usually confirmed by Magnetic resonance imaging (MRI) and histopathology. A 54-year-old male patient presented with progressive bilateral nasal obstruction, more on the right side, associated with hyponasal voice and postnasal discharge of 2 years’ duration. A cystic mass was found by nasal endoscopy on the lateral right side of the nasopharynx, extending to the oropharynx, and was confirmed with MRI findings. Uneventful total surgical excision and marsupialization were done with follow up of nasopharyngeal endoscopic examination on each visit. The pathological features and the site of the cyst were compatible with a second branchial cleft cyst. Although rare, NBC should be considered one of the differential diagnoses of nasopharyngeal tumors. Surgical excision and marsupialization are the main treatment with low complication and recurrence rates.
Relationship between the government implemented protective measures for coronavirus disease 2019 (COVID-19) during the pandemic and the understanding of religious evidence in Muslim community: A cross-sectional study from Saudi Arabia
(2023) Wali, Alzubair A.
Abstract: BACKGROUND: Coronavirus disease 2019 (COVID-19), which has swept across the Middle East has ignited religious tensions. Although the implementation of effective preventive measures is the best way to control the spread of COVID-19, in such countries as Saudi Arabia, these restrictions have sometimes been viewed as violations of religious practice. The present study explores the reasons for ignoring the authorities’ recommendations, and the inability of the authorities to create a sense of inclusion in the protective measures they introduce against the COVID-19 outbreak. MATERIALS AND METHODS: A cross-sectional community-based study was conducted in Saudi Arabia and data were collected from 922 participants. The questionnaire contained 17 questions on personal characteristics, compliance with governmental protective measures, and participants’ understanding of religious evidence. The SPSS was used for data analysis. Categorical data was presented as frequencies and percentages. Chi-square test was used to determine the association between people’s compliance to the protective measures and their understanding of religious evidence. RESULTS: The age of the study participants ranged between 17 to 68 years with a mean age of 43.9 (±12.69) years. About half of the participants reported always complying to Mosque precautions (49.9%) and keeping distance (53.7%). However, only 34.3% participants always maintained social distancing while visiting relatives; about 25.2% often kept a social distance. We found that an adequate understanding of religious principles was significantly associated with accepted overall commitment, and inadequate understanding was significantly associated with lack of commitment. An adequate understanding of religious principles was significantly associated with a positive attitude toward future commitment and inadequate understanding was significantly associated with a negative attitude. CONCLUSION: We recommend that the Ministry of Health in Saudi Arabia solicits the support of religious scholars to give a proper explanation of the religious evidence and eliminate misconceptions to promote compliance with the protective measures.
Prevalence of internalized stigma in patients with psychiatric illness in Abha, Southern Region, Saudi Arabia
(2023) Zarbah, Abdulmajeed A.; Al Alfard, Hayfa A.; Alamri, Hassan S.; Al Edrees, Nada; Alshahrani, Nouf S.; Alshehri, Ali F.
BACKGROUND: Mental stigma occurs when patients with various mental disorders are labeled by their disorders. Little is known about the burden of mental stigma on patients with mental disorders. The aim of this study was to evaluate the incidence of mental stigma on patients with psychiatric disorder in Saudi Arabia. MATERIALS AND METHODS: This cross-sectional study was conducted among previously diagnosed patients with any psychiatric disorder attending King Khalid Hospital, Abha, Saudi Arabia. The patients were interviewed with a sociodemographic questionnaire and a validated Arabic version of the Internalized Stigma of Mental Illness (ISMI-29) scale. Chi-square test and t-test were used to assess the association between various demographic characteristics and presence of stigma. RESULTS: The study included 489 patients with different psychiatric disorders. The mean age of the participants was 32.8 years and 54.6% were females. About 39% participants showed no to minimal internalized stigma, 37.4% of total sample had mild stigma, 20% had moderate stigma, and 3.7% had severe stigma. A signficantly higher proportion (71.4%) of widowed patients had stigma (P = 0.032). CONCLUSION: Self-stigma is prevalent among patients with psychiatric disorders in Abha, Saudi Arabia, but lower than the prevalence in developing countries. Marital status has a significant impact on the prevalence and severity of the self-stigma of patients. There is a need for awareness program to reduce self-stigma. Psychiatric institutions should also focus on promotion of patients’ social life and increase patient’s awareness of certain issues that could prevent stigma.
Predictors of depression among the elderly persons with disabilities in Indonesia
(2023) Widagdo, The Maria M.; Widyaningsih, Bernadeta D.; Layuklinggi, Setywanty
BACKGROUND: Depression is a major mental problem in the elderly, particularly those with disability. This study’s aim was to identify variables that predict depression in the elderly with disabilities. MATERIALS AND METHODS: This cross-sectional study was conducted in Gunungkidul Regency and Yogyakarta City from April to June 2021. The study participants were community-dwelling elderly aged 60 years and above with disabilities, who could communicate verbally without any apparent cognitive impairment. Data was collected by interviewing participants using structured questionnaire on following sections: Demographic characteristics, Mini-Mental State Examination (MMSE), Washington Group Short Set (WG-SS), Barthel Index of activities of daily living (ADL), Lawton Instrumental ADL (IADL) Scale, and Geriatric Depression Scale-30 (GDS-30). Multivariate linear regression analysis applied to identify variables significantly correlated with depression. Multinomial logistic regression analysis performed to obtain the odds ratio (OR). RESULTS: Study included 115 elderly persons with disabilities. Most of them had mobility impairment. Higher independence in ADL and being married were related with lower risk of depression, whereas increased age at disability increased the risk of depression (P = 0.001). The elderly who had greater independence with daily activities were less likely to have depression (OR = 0.639 for mild depression and OR = 0.589 for severe depression). Those who were not married were more likely to have mild depression (OR = 3.203) and severe depression (OR = 29.119). compared to the married elderly. Age at acquiring disability was associated with higher risk for mild depression (OR = 1.025) and severe depression (OR = 1.053). Higher independence in ADL and being married were related with lower risk of depression, whereas increased age at disability increased the risk of depression (P = 0.001). CONCLUSION: Independence in the ADL, being married, and being disabled as a young adult are negative predictors of depression in the elderly with disability.
Brief tele-mindfulness-based intervention: A multicenter randomized controlled trial
(2023) AlQarni, Amani M.; Elfaki, Abdulaziz; Abdel Wahab, Moataza M.; Aljehani, Yasser; Alkhunaizi, Auday A.; Alex, Johnson; Othman, Sharifa A.; Amer, Fatma H.; Alghamdi, Faisal A.; Alissa, Khalid A.
BACKGROUND: Coronavirus disease 2019 (COVID-19) has proven to be detrimental to the psychological well-being of healthcare providers (HCP). This study was a psychological intervention during the COVID-19 pandemic to check extent to which brief mindfulness-based interventions (MBIs) and progressive muscle relaxation (PMR) affect psychological well-being, resilience, and anxiety of HCPs. MATERIALS AND METHODS: A randomized trial study conducted from July to August 2020. One hundred and forty-seven COVID-19 frontline HCPs were randomized to a 2-week virtual intervention with a brief MBI or a PMR. Pre- and postintervention assessments were done using the State-Trait Anxiety–20-Item Scale, the Connor–Davidson Resilience Scale-10, and WHO-5 Well-Being Index. RESULTS: The final sample included 125 HCPs (64 in BMI group and 61 in PMR group) who completed pre- and post-intervention assessment. The results showed a significant improvement in the psychological well-being and reduction of the state anxiety of the two groups, but not in the trait anxiety or resiliency. Improvement was more in the group’s brief MBI (81.3%) than in the group’s PMR (51.8%) (P = 0.0001), concerning psychological well-being. CONCLUSION: Both the brief MBI and PMR improved the psychological well-being and reduced the anxiety of frontline healthcare providers during the COVID-19 pandemic with a slightly better improvement in the brief MBI.
Performance evaluation of health houses in Iraq 2021–2022: A descriptive study
(2023) Al-Ashbal, Mariam A.; Lami, Faris H.
BACKGROUND: A health house (HH) is a basic health facility in rural Iraq. The function of a HH is to provide simple health services and treatments such as giving injections, dressing simple wounds, and monitoring mother and child health. The duties also include dispensing medications, measuring blood pressure, and the daily monitoring of chlorine levels in water. These HHs also provide awareness on different subjects. The main objectives of this study are to assess the availability of the basic features of the HHs and core components of the framework of the World Health Organization (WHO) building blocks. MATERIALS AND METHODS: A multistage sampling technique was used to select 50 HHs out of 497 in Iraq. A questionnaire comprising closed-ended questions was developed to be completed using the researcher’s observations and interviews with the healthcare workers in the HHs. The questionnaire covered the basic features of HHs as recommended by the Iraq Ministry of Health (MOH) and the six WHO health system building blocks. RESULTS: Fifty HHs were enrolled in the study. The availability score of basic features was 43.6% and the general service score was 55.1%. The service-specific score was 23.3%, the health workforce score was 29.6%, and the health information system score was 79.5%. The availability of essential medicines score was 21.2%, the health financing system score was 0.0%, and the leadership and governance score was 66.7%. CONCLUSION: The HHs need to follow the standard criteria determined by the Iraq MOH to ensure the proper functioning of the health outlets.

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