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A rare invasive male breast cancer of nonspecific type presenting at a primary care clinic: Importance of early diagnosis and management
(2023) Mansoor, Nurulhana S.; Arifin, Farnaza; Kornain, Noor K.M.; Razalli, Mazuin M.
Abstract: Male breast cancer is a rare disease with an incidence rate of <1% of all breast cancer cases, and only 1% of all male malignancies. Men tend to present at an older age and with more advanced stages compared to women. We report a case of a 74-year-old man who presented at a primary care clinic with a right subareolar painless breast mass. A mammogram and core biopsy were performed. A diagnosis of right invasive breast carcinoma was rendered. The patient underwent a right total mastectomy with ipsilateral axillary lymph node dissection, which revealed an invasive ductal carcinoma of no special type (NST). Chemotherapy, radiotherapy, and hormonal therapy were included in the adjuvant treatment plan. In this report, we discuss the important role of the primary care physician (PCP) in early diagnosis and referral for definitive management. The PCP also plays an essential role in the holistic care of male breast cancer patients, including the management of physical, psychological, social, and underlying chronic diseases.
Accuracy of body mass index compared to whole-body dual energy X-ray absorptiometry in diagnosing obesity in adults in the Eastern Province of Saudi Arabia: A cross-sectional study
(2023) Alqarni, Amani M.; Aljabr, Abdullah S.; Abdelwahab, Moataza M.; Alhallafi, Ahmed H.; Alessa, Mustafa T.; Alreedy, Abdullah H.; Elmaki, Sara A.; Alamer, Naheel A.; Darwish, Magdy A.
BACKGROUND: Obesity is a major health concern that requires accurate diagnosis and management. Body mass index (BMI) commonly used to diagnose obesity, has limitations in accurately assessing body fat. Body fat percentage (BF%) from whole-body dual energy X-ray absorptiometry (DEXA) scans is gaining popularity as a more accurate method in diagnosing obesity. MATERIALS AND METHODS: This cross-sectional study included 319 adult patients who underwent whole-body DEXA scans in the Eastern Province of Saudi Arabia from May 2016 to December 2021 were recruited from three medical centers, where data for whole-body DEXA were available. Body fat percent was obtained from the whole-body DEXA scan reports and were compared to BMI to evaluate prevalence of obesity. Data was extracted by reviewing patients’ records using a structured data collection tool. BMI was defined using WHO criteria, and diagnostic performance was assessed by estimating specificity, sensitivity, likelihood ratios, and predictive values, and by constructing receiver operating characteristic (ROC) curves for BMI to detect obesity by age group. RESULTS: The gender-specific BF% cutoff points revealed a higher prevalence of obesity than BMI cutoff points. BMI misclassified 40.6% of participants, and optimal cutoff points yielding highest area under the curve were 24 kg/m2 and 24.3 kg/m2 for males and females, respectively. CONCLUSION: The study underscores the importance of using accurate and comprehensive diagnostic tools such as whole-body DEXA scans to assess obesity.
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.
Application of sharia childbirth innovation model in Indonesia: Perspective of midwives and staff of the Islamic Service Unit
(2023) Suryani, Lilis; Kamil, Hajjul; Hasanuddin, Hasanuddin; Yahya, Mustanir; Sulastri, Sulastri; Agustina, Agustina; Hamzah, Safnita; Ramadhan, Nurlaila
BACKGROUND: The implementation of Sharia Model Childbirth (SMC) is in accordance with Fatwa Majelis Ulama Indonesia (MUI) no l07/DSN-MUI/X/2016 on the practice of sharia principles in health services. Sharia services in hospitals are general. This SMC innovation is specific and comprehensive, covering prenatal, delivery and postnatal. This model was implemented in 2017 but has never been qualitatively evaluated. The purpose of this study was to evaluate the application of SMC in the maternity services from the perspective of midwives and staff of the Islamic service unit. MATERIALS AND METHODS: Applied qualitative research was conducted from 5 December 2021 to 31 January 2022. In-person in-depth interviews were conducted using semi-structured interview guidelines. Informants were taken from the midwives of the maternity room and the Islamic service installation until a fair saturation of data was achieved. Observational and documentation were conducted for the validity of the data. The data were analyzed thematically and presented in themes and sub-themes. RESULTS: The results of the study were on the work procedures implemented, and the obstacles and shortcomings found. Most of the procedures and accompanying regulations had been implemented. Participants revealed obstacles and shortcomings in this innovative program. The major obstacle found was that the patient’s right to choose a female medical officer was not fulfilled because of the type of teaching hospital it was and the lack of female medical staff. The shortcomings were in the reading of prayers and remembrances, the understanding of the contents of the manual, and the design of the delivery room, which did not maintain privacy. CONCLUSION: Overall, SMC is being implemented, but there are obstacles and shortcomings in the implementation. Solutions and regulations in sharia services should urgently be found and enforced. The deficiencies in this innovative program must be corrected immediately.
Arabic Abstracts
(2023)
Arabic Abstracts
(2023)
Arabic Abstracts
(2023)
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.
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.
Attention-deficit hyperactivity disorder in Egyptian medical students and how it relates to their academic performance
(2023) Shebl, Eman M.; Abu Bakr Elsaid, Noha M.; Hassan, Hend A.; Kamal, Doaa; Araby, Eman
BACKGROUND: The neurobehavioral disorder, known as attention-deficit hyperactivity disorder (ADHD), is characterized by impulsivity, hyperactivity, and a lack of focus. In addition, it is connected to poor academic performance. The purpose of this study was to determine the prevalence of ADHD and its effect on their academic performance among medical students. MATERIALS AND METHODS: This web-based cross-sectional study was conducted among medical students of four medical colleges during December 2021 and April 2022. Data was collected using a self-administered questionnaire comprising Wender Utah Rating Scale and adult ADHD Self-Report Scale [ASRS]. The link to Google Form survey was distributed to students through academic emails and WhatsApp. Data analyzed using SPSS; Chisquare test or Fisher’s exact test as appropriate, were used to determine statistical significance. RESULTS: A total of 990 students filled online questionnaire; 54.7% were females.. The estimated prevalence of ADHD in Egyptian medical students was 11%. Students who had childhood ADHD were significantly linked with the present ADHD (r = 0.54, P < 0.001). There was a negative correlation between the ASRS score for ADHD and students’ GPA (r = 0.2, P < 0.001). No statistically significant association was observed between ADHD and sex, type of university, and academic level. of the students. CONCLUSION: ADHD is prevalent among medical students. Since most of our students with adult ADHD also had preexisting childhood ADHD, it is crucial that the primary care services, especially school health services, have appropriate standards for the early identification and management of ADHD. Health authorities should conduct a comprehensive health education campaign to raise public awareness of ADHD and its risk factors, the clinical picture, and the burden.
Attitude of family medicine residents toward team-based care in primary healthcare centers in Saudi Arabia
(2023) Haji, Alhan M. A.
BACKGROUND: Team-based care (TBC) is becoming the standard method of delivering primary care services in Saudi Arabia. Family medicine residents are considered the future leaders who will apply the Saudi Ministry of Health (MOH) strategic transformation plans in practice. The aim of this study was to assess the attitude of family medicine residents toward TBC and the factors associated with their current attitudes. MATERIALS AND METHODS: A cross-sectional study was conducted between February and April 2022. The study targeted all Family Medicine residents rotating in primary healthcare centers of the Saudi MOH. A web-based survey was built using a modified version of the Attitudes Toward Health-Care Teams Scale. Data was analyzed using SPSS. Mann-Whitney U test and analysis of variance (ANOVA) were performed to compare mean attitude scores between various study variables. RESULTS: The overall mean attitude score was 2.71; the mean scores for attitudes toward team value, team efficiency, and physicians shared role were 3.94, 2.47, and 1.71, respectively. The residents who had received TBC training had significantly higher mean scores for attitudes toward team value subscale compared to those who had no training (4.09 vs. 3.87, P = 0.038). Similarly, the mean score for same attitude subscale was significantly higher among those who practice TBC compared to those who do not (4.08 vs. 3.85, P = 0.038). CONCLUSION: The residents exhibited an overall positive attitude, especially toward team value; however, their understanding of physicians’ shared role in the team should be improved by training and practice with role models.
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.
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.
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.
Dietary habits, lifestyle changes, and glycemic control in patients with type 2 diabetes mellitus during coronavirus disease 2019 (COVID-19): A cross-sectional study in Egypt
(2023) Hussein, Yasmin H. H.; Soliman, Al-Zahraa M.
Abstract: BACKGROUND: The coronavirus disease 2019 (COVID-19) lockdown had a significant effect on people’s lifestyles and dietary habits resulting in a possible negative health impact, particularly for patients with type-2 diabetes mellitus (T2DM). The objective of the study was to assess the changes in dietary habits and lifestyle and how these relate to glycemic control in patients with type 2 diabetes (T2D), who attended Zagazig Diabetes Clinic, Sharkia Governorate, Egypt, during the COVID-19 pandemic. MATERIALS AND METHODS: A total of 402 patients with T2D were included in this cross-sectional study. A semistructured questionnaire was used to collect information on socioeconomic status, dietary habits, lifestyle changes, and previous medical history. Weight and height were also measured, and hemoglobin A1C levels before and after lockdown were compared. Data analysis was performed using the SPSS. To determine statistical significance, Chi-square test was used for categorical variables whereas, paired t-test or McN-Nemar test, as appropriate, was used to compare change in HbA1c before and after lockdown. Ordinal logistic regression was used to determine factors associated with weight change, whereas binary logistic regression was used to determine factors related with glycemic control. RESULTS: During the COVID-19 pandemic, 43.8% of the studied groups consumed more than their usual diet with an increase in fruits, vegetables, and immunity-boosting food; 57% depended on home-cooked food, 48.3% did not practice exercise. About 57% reported to have gained weight, 70.9% suffered from mental stress, and 66.7% reported inadequate sleep. Collectively, there was a statistically significant decrease in the percentage of good glycemic control in the studied groups (28.1% vs. 15.9%) before and after the COVID-19 lockdown, respectively (P < 0.001). Weight gain, physical inactivity, mental stress, and inadequate sleep were significantly associated with poor glycemic control. CONCLUSION: COVID-19 pandemic has had a negative impact on the lifestyle and dietary habits of the studied groups. Therefore, it is very important to ensure better diabetes management in this critical period.
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.
Early detection system of risk factors for diabetes mellitus type 2 utilization of machine learning-random forest
(2023) Ginting, Johannes B.; Suci, Tri; Ginting, Chrismis N.; Girsang, Ermi
BACKGROUND: The prevalence of morbidity and mortality for type 2 diabetes mellitus (DM) is still increasing because of changing lifestyles. There needs to be a means of controlling the rise in the incidence of the disease. Many researchers have utilized technological advances such as machine learning for disease prevention and control, especially in noncommunicable conditions. Researchers are, therefore, interested in creating an early detection system for risk factors of type 2 diabetes. MATERIALS AND METHODS: The study was conducted in February 2022, utilizing secondary surveillance data from Puskesmas Johar Baru, Jakarta, in 2019, 2020, and 2021. Data was analyzed utilizing various bivariate and multivariate statistical methods at 5% significance level and machine learning methods (random forest algorithm) with an accuracy rate of >80%. The data for the three years was cleaned, normalized, and merged. RESULTS: The final population was 65,533 visits out of the initial data of 196,949, and the final number of DM 2 population was 2766 out of the initial data of 9903. Age, gender, family history of DM, family history of hypertension, hypertension, high blood sugar levels, obesity, and central obesity were significantly associated with type 2 DM. Family history was the strongest risk factor of all independent variables, odds ratio of 15.101. The classification results of feature importance, with an accuracy rate of 84%, obtained in order were age, blood sugar level, and body mass index. CONCLUSION: Blood sugar level is the most influential factor in the incidence of DM in Puskesmas Johar Baru. In other words, a person with a family history of type 2 diabetes, at unproductive age, of female gender, and of excessive weight can avoid type 2 diabetes if they can regularly maintain their blood sugar levels.
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.
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.
Emergency versus elective cholecystectomy: Experience at a university hospital in the Eastern Province, Saudi Arabia
(2023) Amer, Nasser M.; Alarfaj, Mosab A.; Othman, Sharifah A.; Alshammary, Shadi; Alshammari, Eiman M.
Abstract: BACKGROUND: Laparoscopic cholecystectomy (LC), the procedure of choice for treating most gallbladder pathology, has become the most trusted elective procedure for treating gallstone disease because of its effectiveness and safety. While the timing is an important factor in those cases, our aim in this study was to compare emergency and elective LC, determine the differences in postoperative complications, and assess the conversion rate to open cholecystectomy. MATERIALS AND METHODS: This study included a total of 627 patients who had undergone laparoscopic cholecystectomy during 2017-2019 at King Fahd Hospital of the University (KFHU). Records of both emergency and elective cases were reviewed from Quadra-med (software package). All demographic data of the patients, presenting complaint, laboratory and inflammatory marker, type of the operation, intraoperative complications, procedure time, conversion rate from laparoscopic to open cholecystectomy, postoperative period, length of hospital stay, and pathological diagnosis were entered into an Excel sheet. The data was analyzed using SPSS 23.0. Qualitative variables were described as frequencies and percentages, and continuous variables were summarized with mean and standard deviation (SD). Chi-square test, t-test, and the Mann–Whitney U-test were applied to test for statistical significance at P ≤ 0.05. RESULTS: The mean age for patients undergoing elective LC was 39.94 years (SD=13.56) whereas, mean age of patients undergoing emergency LC was 40.64 years (SD=13.02). About 71% of cases in elective LC group were females compared to 55% in the emergency LC group. There was a significant difference in C-reactive protein (CRP) in relation to the type of surgery where P < 0.05. Twelve (1.9%) patients had subtotal cholecystectomy and two cases converted from LC to open. There was a significant association between postoperative complication and the type of surgery. The length of hospital stay (LOS) was also found to be significantly more in patients having emergency LC (6.0 vs. 4.5 d; P < 0.05). CONCLUSION: The relation between conversion to an open procedure and type of surgery (elective or emergency) in our study was nonsignificant. There was a significant association between preoperative CRP, postoperative complication, length of hospital stay, and type of surgery. Further multicenter studies are required for further investigation.

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