Family violence among female medical students: its prevalence and impact on their mental health status - a cross-sectional study

Violence against women is recognized worldwide as a major public health problem. Studies show that violence affects the mental well-being of the victims. The study explores the prevalence of family violence among Saudi female medical students and its relationship with students' mental well-being and seeks to identify the effect of violence on students' academic achievements. This was a cross-sectional study on 1st- to 5th year Saudi female medical students, utilizing a validated violence screening questionnaire that asked the respondents about how often they were physically Hurt, Insulted, Threatened with harm, and Screamed at [HITS]. Furthermore, the study administered a validated mental well-being questionnaire, the Mental Health Inventory 5 [MHI-5], for the assessment of the mental status of the respondents. The analyses included simple univariate analyses, bivariate analyses and linear regression modelling. Of the total of 460 Saudi female medical students, 363 [79%] students participated in this study. Nineteen [5.3%] students confirmed being the victims of family violence. The victims had a mean MHI-5 score of 52%. A negative correlation was observed between violence and mental well-being scores. Significant association between the MHI-5 score and academic achievement was observed. The prevalence of family violence in this study is less than the reported figures in other studies. We could not demonstrate a direct relationship between family violence and academic achievement. Students' academic achievement was indirectly associated with the presence of family violence through changes in mental well-being

validation study comparing the sensitivity and specificity of the new Dr. KSU H1N1 RT-PCR kit with reAl time RT-PCR for diagnosing influenza A [H1N1]

A new test [Dr. KSU H1N1 RT-PCR kit] was recently developed to provide a less expensive alternative to reAl time reverse transcriptase-polymerase chain reaction [RT-PCR]. We report the findings of a validation study designed to assess the diagnostic accuracy, including sensitivity and specificity, of the new kit, as compared to reAl time RT-PCR. Cross-sectional validation study conducted from 18-22 November 2009 at a primary care clinic for H1N1 at a tertiary care teaching hospital in Riyadh. Nasopharyngeal swab samples and data on socio-demographic characteristics and symptoms were collected from 186 patients. Swab samples were sent to the laboratory for testing with both reAl time RT-PCR and the new Dr. KSU H1N1 RT-PCR kit. We measured the sensitivity and specificity of the new test across the entire sample size and investigated how these values were affected by patient socio-demographic characteristics and symptoms. The outcomes of the two tests were highly correlated [kappa=0.85; P<.0001]. The sensitivity and specificity of the new test were 99.11% and 83.78%, respectively. The sensitivity of the new test was affected only minimally [96%-100%] by patient characteristics and number of symptoms. On the other hand, the specificity of the new test varied depending on how soon patients were tested after onset of symptoms [100% specificity when swabs were taken on the first day of the symptoms, decreasing to 75% when swabs were taken on or after the third day]. The specificity of the new test also increased with increasing body temperature. The new test seems to provide a cost-effective alternative to reAl time RT-PCR for diagnosing H1N1 influenza. However, further testing may be needed to verify the efficacy of the test in different settings and communities

Towards evidence-based clinical practice guidelines in Saudi Arabia

The objective of this review is to provide a brief background on clinical practice guidelines CPGs and tools to assess and locally adapt CPGs. Over the last 2 decades, CPGs have become an increasingly popular tool for synthesis of clinical information, so as to change clinical practice and improve quality of health care. Such a quantitative growth in the number of guidelines available in different specialties is a source of concern since there is evidence that recommendations produced by different groups can be conflicting, invalid, unreliable, and even harmful. Various critical appraisal instruments were designed and tested to assess whether developers have minimized the biases inherent in creating guidelines and addressed the requirements for effective implementation. We recommend using the AGREE instrument which was developed by the Appraisal of Guideline Research and Evaluation AGREE collaboration. It is the most well-developed guideline appraisal instrument available, and it has been shown to have good reliability and validity. There is a growing recognition that it is not possible for national guidelines to be produced on every clinical problem of concern. The cost is huge and few practices have the resources or skills to develop their own valid evidence-based guidelines. Several developed countries encourage local adaptation of international good quality guidelines to avoid duplication of work and cost involved in guidelines development. Therefore wherever possible, Saudi guidelines should be based on existing good quality guidelines. The methodology for local adaptation of CPGs to meet the local needs and resources are explained in this review

Diagnostic agreement between primary care physicians and neurologists

The ability of primary care physicians [PCP[s]] to diagnose neurologic disorders was assessed from the records of 166 patients referred to the neurology outpatient clinic in one year. At the time of referral, 74.7% were correctly diagnosed. Primary care physicians were competent in the diagnosis of cerebrovascular accidents, epilepsy, space-occupying lesions, dementia, extrapyramidal and cerebellar disorders. More specific diagnosis was difficult at the primary care level in cases of headache, spinal cord and peripheral nerve disorders. The implications of these results and possible reasons for them are discussed. Solutions to improve on this situation are recommended with emphasis on both undergraduate and postgraduate training in neurological bedside skills. The complementary roles of the primary care physician and the neurologist are stressed