Does Academic Performance Affect the Perceived Value of Mentorship, and Mentor s Influence on Student s Satisfaction? A Cross Sectional Study

An effective mentorship can greatly help medical students in achieving personal and professional success, and satisfaction. Mentorship efforts are therefore gaining increasing importance in medical education. It is important to make a realistic appraisal of factors that can affect the outcome of mentorship exercise, so that specific improvement in mentorship strategy can be made. Academic performance correlates with students’ ability to handle learning stress, and their professional and personal competence. This study aims at identifying the perceived value of mentorship in medical students. MethodsA cross-sectional survey was conducted among graduate medical students at the College of Medicine, Majmaah University, in October 2019. The mentees completed an anonymous questionnaire about the perceived quality of the mentorship. Academic performance was evaluated from Garde Point Average (GPA), whether the student has repeated one or more years in the college, and the number of academic papers published by the student. Kruskal–Wallis test was used to determine significant differences among groups. Two-tailed p-value was used to evaluate the statistical significance. ResultsThe questionnaire was sent to 337 mentees. The response rate was 67.7 % and the average age of mentees was 21.9 ± 1.4 years. 276 (98 %) mentees were unmarried and 171 (61 %) were men. 78 (27.7 %) mentees had a GPA of 4.5 - 5. 76 (27.0 %) mentees repeated one or more years in the college. 214 (75.9 %) mentees did not have any publication. More men than women had one or more published papers (men 29.2 % vs women 15.2 % , p = 0.04), The median score of Mentorship Relationship Structure (MRS) for the GPA 2 - 2.5 was 8 (IQR = 15) and it increased to 25 (IQR = 12.2) in the group with GPA 4.5 - 5 (p = 0.004). On MRS, there was no effect of repeating a year in college or the number of papers published (both, p > 0.05). ConclusionsThe mentees with extremely low and high GPA can have different perceived quality of the mentorship. The mentorship exercise should be customized to address the specific needs and motivational status of mentees with low and high GPA.

Concomitant administration of atorvastatin with N-acetylcysteine mitigates liver injury and steatosis in experimental non-alcoholic fatty liver disease

Although numerous efforts have been directed toward searching for new treatments against non-alcoholic fatty liverdisease (NAFLD), there are no approved pharmacologic agents up to date. This study evaluates the therapeutic effectof concomitant administration of atorvastatin (ATO) and N-Acetylcysteine (NAC) with/without diet control. Ninegroups of rats were divided into: normal, rats fed on high-fat diet for 12 weeks (NAFLD-HFD model), HFD-ratsswitched to regular diet (NAFLD-RD model), NAFLD-HFD or -RD rats treated with either ATO or NAC orally with30 or 500 mg/kg/day, respectively, or both for 8 weeks. NAFLD-HFD rats exhibited remarkable steatosis with lobularinflammation, hepatocytes vacuolation, and fibrosis, as well as significant changes in lipid profile, oxidative stress,and adipocytokines and these manifestations were less prominent in the HFD-RD group. ATO and NAC combinationwith diet control has the added benefits on ameliorating lipid levels, liver enzymes, oxidative stress, hepatic steatosis(9.01% ± 1.66% vs. 13.21% ± 2.20% for ATO and 25.60% ± 2.11% for NAC), inflammation, hepatocyte vacuolation,and fibrosis versus each drug separately. Conclusion: ATO and NAC concomitant therapy has a greater effect onNAFLD as compared to monotherapy and is recommended for further investigation in clinical trials.

Intrauterine Misoprostol versus intravenous Oxytocin infusion during cesarean delivery to reduce intraoperative and postoperative blood loss: a randomised clinical trial

Background: The objective of the present study was to compare the efficacy of intrauterine misoprostol with intravenous oxytocin infusion in reducing blood loss during and after cesarean section (CS).Methods: An open, randomized, clinical trial, registered (ClinicalTrials.gov ID: NCT03148574) conducted between July 1, 2017 and April 1, 2018. The study included 240 pregnant females that were recruited at term (37-40 weeks) gestation scheduled for either elective or emergency CS. Eligible participants were randomly allocated into two equal groups: Group A: patients who receive intravenous infusion of 10 I.U diluted to 500ml of normal saline for 30 minute after delivery. Group B: patients received 400μg misoprostol intrauterine just after cord clamping and delivery of the placenta. Primary outcome measure was assessment of amount of intraoperative and postoperative blood loss.Results: The intraoperative and 2h postoperative blood loss in the misoprostol group was higher than oxytocin group (p<0.001). Hemoglobin level decreased significantly among both groups, manifested by the highly significant p value in comparison of pre and postoperative Hb level in the two groups (p<0.001). However, the blood loss in the misoprostol group was higher than oxytocin group (p=0.004). There was a statistical significant differences between both groups as regards the need for additional uterotonic drug (66% in misoprostol group vs 5% in oxytocin group, P<0.001). Shivering and pyrexia were more in common in the misoprostol group while vomiting, headache and giddiness were significantly higher among oxytocin group.Conclusions: Administration of misoprostol 400mcg through intrauterine route appears to be less effective than intravenous oxytocin infusion in reducing blood loss during and after CS.

Prevalence of Anxiety and Depression and its Related Influencing Factors among Patients with End-stage Renal Disease on Hemodialysis in Al-Kharj, Saudi Arabia

Background: Chronic kidney disease (CKD) and End-stage renal disease (ESRD) is a prevalent and important non-communicable condition that poses a long-term global health burden. In Saudi Arabia, the previously available literature on the topic does not present sufficient evidence to produce sound guidelines for a better outcome and healthier life for the patients on hemodialysis. Objective: To assess the prevalence of anxiety and depression and its related influencing factors among CKD and ESRD patients on hemodialysis at the dialysis unit of King Khaled and the Military hospital in Al-Kharj city. Methodology: A cross-sectional study of Al-Kharj city’s major hospitals was conducted from December 2016 to January 2017. The study included 144 CKD and ESRD patients on hemodialysis using a stringent set of inclusion and exclusion criteria. A standard self-administered questionnaire-the Hospital Anxiety and Depression Scale (HADS) was used in the study to measure the presence and severity of anxiety and depression in the study population. Appropriate statistical tests were used to identify associations between relevant factors and anxiety/depression. Results: Results were collated from 116 patients. There were 66 males and 50 females with a mean age of 52.33 ± 16.17 years. Overall, 12%, 4.31%, 27.6%, and 23.3% of patients reported borderline anxiety, abnormal anxiety, borderline depression, and abnormal depression, respectively. Conclusion: The present study does not provide a statistically significant association between anxiety/depression and hemodialysis; however, anxiety and depression should be investigated among the patients on hemodialysis as these disorders commonly coexist with CKD and ESRD, and they affect the quality of life.

Unilateral supraglottoplasty for severe laryngomalacia in children

To study the efficacy of Unilateral Supraglottoplasty [USGP] in treating severe laryngomalacia [LM] in children. Retrospective Medical Record Study. Aseer Central Hospital and Abha Private Hospital, Saudi Arabia. Thirty-seven patients, aged 7 days to 9 months underwent Unilateral Supraglottoplasty for severe LM from January 2000 to December 2014. Patients who underwent preoperative tracheotomy and or previous airway surgery were excluded. Successful extubation in the second postoperative day was achieved in 31 [84%] patients; contralateral supraglottoplasty [CSGP] was required in 6 patients [16%]. Aspiration was noticed in 2 [5%] patients and 1 [3%] developed supraglottic stenosis [SGS]. USGP was found to be safe surgical procedure with high success and low complication rate for treating severe LM

[Evaluation of maximum levator resection in management of severe Blepharoptosis]

Objective: To study the efficacy of maximal levator resection in patients with severe ptosis with poor levator function [LF]

Patients and methods: 31 patients with severe ptosis underwent maximal levator resection.Palpebral fissure height and LF were assessed preoperatively and postoperatively. Results: All patients showed an excellent reduction in ptosis with a single intervention resulting in a clear visual axis. Palpebral fissure height improved from means [SD] 2.98 preoperatively to 7.70 postoperatively [P value <0.001], No patients underwent additional surgery because of cosmetic issues. All patients showed a marked, consistent, and lasting improvement in LF, going from mean [SD] 2.60 preoperatively to 7.82 postoperatively [P value < 0.001]

Conclusions: Maximal levator resection is an effective surgical technique in management of patients with severe ptosis with good cosmetic appearance in terms of ptosis reduction in the majority of cases and with a significant increase of the levator palpebrae superioris function

prevalence of physical activity and its socioeconomic correlates in Kingdom of Saudi Arabia: a cross-sectional population-based national survey

To determine the levels of physical activity in the Saudi population and to assess its socio-demographic correlates. The data were part of a cross-sectional representative national survey of 4758 participants conducted in Kingdom of Saudi Arabia. A multistage stratified cluster random sampling design was used. Physical activity was assessed using the Global Physical Activity Questionnaire [GPAQ] version 2.0. Logistic regression analyses were used to identify the determinants and were adjusted in relation to various factors. Overall, physical inactivity was found to be 66.6% [95% C.I.: 65.3%-68%], 60.1% [95% C.I.: 58.1% - 62.1%] for males and 72.9% [95% C.I.: 71.1%-74.7%] for females. Leisure time physical inactivity was found to be 87.9%, 85.6% for males and 90.2% for females. The northern and central regions reported the highest prevalence of no physical activity at work, leisure and transportation. Gender, geographical location and employment status exhibited a statistically significant correlation. There is a high level of physical inactivity in various regions and population groups in the Kingdom of Saudi Arabia. Population interventions are greatly needed, especially those focusing on physical activity in their leisure time

Pharmacological and antioxidant actions of garlic and/or onion in non-alcoholic fatty liver disease [NAFLD] in rats

Non-alcoholic fatty liver disease [NAFLD] includes a broad spectrum of fat-induced liver injury, ranging from mild steatosis to cirrhosis and liver failure. This study investigates the hepatoprotective properties of garlic and onion in NAFLD rat model. Ninety male Sprague-Dawley rats were randomly divided into 9 groups; normal [I], NAFLD induced with high fat diet [HFD; II], NAFLD switched to regular diet [RD; III], NAFLD-HFD or NAFLD-RD treated with garlic [IV, V] onion [VI, VII] or the combined garlic+onion [VIII, IX] respectively. A NAFLD rat model was established by feeding the animals with a high-fat diet for 12 wk. These animals were then treated with garlic or/and onion or vehicle for 8 wk [weeks 13-20] and then killed to obtain serum samples and liver tissues. Liver histology, lipids, parameters of oxidative stress, TNF-alpha and TGF-p were measured. The liver in NAFLD-HFD showed typical steatosis, accompanied with mild to moderate lobular inflammatory cell infiltration. Serum levels of ALT, AST, ALP, leptin, cholesterol, triglycerides, TNF-alpha, TGF-P and hepatic MDA were significantly increased [P<0.05] compared with normal group. This was accompanied with reduction of hepatic GSH, GR, GPx, GST, SOD and serum adiponectin. These changes were to a less degree in NAFLD-RD group. Combined administration of garlic+onion produced a better and significant decrease in liver steatosis, serum liver enzymes, oxidative markers and lipid peroxidation versus each one alone. In the same time, NAFLD-induced inflammation was also mitigated via reduction of TNF-alpha and TGF-P. In addition, these results were better in the group IX versus group VIII

description of haemogregarina species naturally infecting white-spotted gecko [tarentola annularis] in Qena, Egypt

The present study describes the developmental stages of Haemogregarina species in the blood and tissues of naturally infecting white-spotted gecko Tarentola annularis collected from Qena, Egypt. Different parasite's forms were observed infecting the erythrocytes. The gamonts enclosed within parasitophorous vacuole and seems to have no clear effect on the host cell especially in case of immature parasite forms. But in the presence of mature gamonts the host cell nucleus displaced. The parasitaemia level is up to 280 per 10,000 erythrocytes counted. Trophozoites and gamonts have been recognized in the blood smears. The rounded trophozoite diameter is 3.84 +/- 0.87 fim, while the elongated trophozoite measured 4.42 +/- 0.692.8 +/- 0.56 microm. The mature gamonts were differentiated into two forms; short gamont measuring 10.82 +/- 0.82x3.30 +/- 0.73 microm [range: 10-12.1x2.2-4.4 micronm] and the long gamont measured 14.67 +/- 0.83x3.96 +/- 0.77 |nm [range: 14.1-16.5x3.3-5.5 urn]. Merogony carried out only in the endothelial cells of the blood capillaries in the lung. Different merogonic stages have been recognized and differentiated in two forms; micromeront measured 13.25+0.50x12+0.0 |um and produces a few number of large merozoites, macromeront measured 19.75+0.87xl3.25 +/- 0.50 |nm and produces more small sized merozoites. The gamonts and merozoites have the general characteristic ultrastructures of the Apicomplexa containing components of the apical complex, e.g. pellicle, micronemes, rhoptries, and few dense bodies and subpellicular microtubules

[Study of the chemical compositions of the Ocimum Basilicum family Lamiaceae]

The aim of this study is to determine the essential oil of Ocimum and to find out the chemical constituents of essential oils of Yemeni Ocimum basilicum Lamiaceae. Two samples of Ocimum basilicum which were collected from Sana'a region, Yemen. The color of leaves was green and purple. Oils were isolated from fresh leaves. The constituents are quantified using Gas Chromatograph equipped with Mass Spectrometry. The analysis of the oils resulted in the identification of twenty six constituents. Fifteen constituents were identified from green phenotype oil. Linalool [46.6%], verbenone, [10.0%], methyl chavicol [8.1%], geraniol [7.3%], 1, 8-cineole [7.1%] and borneol [4.3%] were found to be the major constituents in the oil distilled from green phenotype. Eleven constituents were identified from purple phenotype oil with linalool [41.8%], methyl chavicol [30.9%], 1, 8-cineole [9.7%] and TAU-cadinol [4.2%] as the major constituents. The study revealed that two chemo-types were identified. The isolated oils could be classified as the linalool - methyl chavicol [European chemotype] and linalool-verbenone -methyl chavicol chemotype, which to the best of our knowledge has not been reported so far

Perspectives on specialist nursing in Saudi Arabia: a national model for success

In many parts of the world, vulnerable patient populations may be cared for by a clinical nurse specialist [CNS]. Nurses desiring to develop themselves professionally in the clinical arena, within the specialty of their choice, have the opportunity to obtain the knowledge, skills, experience and qualifications necessary to attain advanced practice positions such as CNS or nurse consultant [NC]. Although studies have demonstrated the benefits of such roles and while the World Health Organization [WHO] recommends it, advanced nursing practice is not yet integrated into the health care culture in Saudi Arabia. The reasons for this are multiple, but the most important is the poor image of clinical nursing throughout the country. This article aims to share a perspective on CNS practice, while casting light on some of the obstacles encountered within Saudi Arabia. A model is proposed representing specialist nurse-physician collaborative practice for implementation nationally. The model has been implemented in the care of the colorectal and stoma patient populations while taking into consideration patient population needs and local health care culture. This model is based on the concepts of holistic "patient-centered care", specialist nurse-physician collaborative practice, and the four practice domains for NCs [expert practice, leadership, research and education] as indicated by the Department of Health in the United Kingdom. We suggest this model will enable the introduction of advanced specialist nursing and collaborative partnerships in Saudi Arabia with benefits for patients, physicians, health care organizations and the nursing profession as a whole

Comparative study of physical activity of hypertensives and normotensives: a cross-sectional study of adults in Saudi Arabia

quantify the magnitude of the disease and its risk factors. The patterns of physical activity have not been studied in terms of their being a risk factor or a predictor of hypertension in Saudi Arabia. This was a community-based cross-sectional study using the STEP-wise approach of adults and Q a multistage, stratified, cluster random sample. Data were collected using a questionnaire which included sociodemographics, blood pressure, patterns, levels and duration of physical activity. Of a total DC of 4758, 1213 [25.5%] were hypertensives. Hypertension was significantly negatively associated with total Vl. levels and duration of physical activity in leisure, transport, and work. Significant predictors of hypertension Q] included lower levels of work involving a moderate physical activity for 10 min, walking/cycling for 10 min

Laparoscopic versus open cholecystectomy in patients with gallstone disease admitted to Aden public hospitals, Yemen

Gallstone disease is a common surgical pathology and major cause of morbidity. In Yemen-Aden, remote studies confirmed the high incidence of gallstone disease. To compare both procedures by age, sex, risk factors, operation length, morbidity, postoperative pain and hospital stay. To identify risk factors for intra-operative conversion and post-operative morbidity. This is a prospective and observational comparison between open cholecystectomy [OC] and laparoscopic cholecystectomy [LC] in symptomatic gallstone patients, conducted in Aden hospitals, between Jan 2004 to Dec 2005. Cholecystectomy were performed in 116 patients. Fifty had OC and 66 LC. Males were 8 and females were 108 Male to female ratio was 1: 9 and mean age 45.6 years. Operation time was 85 minutes for OC and 80 LC. Intraoperative complications were statistically significant in LC while postoperative morbidity was not significant [11.7% LC Vs 8.0% OC]. Conversion rate for LC was 9.1%. In LC, age of 60 and acute cholecystitis were statistically related to postoperative morbidity. Significant mild postoperative pain was found in LC and severe pain OC. Mean hospital stay was shorter with LC group. LC is a safe technique with better postoperative hospital stay and less pain, without difference in operative characteristics, morbidity and mortality. Despite early experience in LC, the acceptable conversion rate and morbidity are good initial outcome measures. We recommend training programs in laparoscopic surgery and establishment of a well equiped diagnostic and therapeutic endoscopic unit

Ruptured ileocolic artery aneurysm: An unusual cause of hemoperitoneum

Ruptured aneurysm of a branch of ileocolic artery is a rare finding and is an unusual cause of haemoperitoneum. Rapid diagnosis, and surgical or endovascular intervention are necessary to avoid devastating consequences and high mortality rates following an emergency operation after rupture. Resection is a good choice for surgical intervention for some aneurysms that are not suitable for endovascular repair. This report describes the case of a middle-aged man with a ruptured superior mesenteric artery branch aneurysm and his subsequent surgical management.

Avaliação do estresse oxidativo no sangue de consumidores habituais de suco de laranja / Evaluation of serum oxidative stress in regular consumers of orange juice

Dois biomarcadores do estresse oxidativo foram avaliados em indivíduos saudáveis que receberam doses diárias de suco de laranja, notadamente uma fonte de vitamina C e de flavanonas, que têm sido associadas aos efeitos antioxidante, anti-inflamatório e hipolipidêmico. A capacidade antioxidante do soro sanguíneo foi avaliada através da redução do radical 2,2-difenil-1-picril-hidrazila (DPPH) e a peroxidação lipídica foi avaliada pela presença de substâncias reativas ao ácido tiobarbitúrico (TBARS). Os resultados mostraram que após o período de suplementação com o suco de laranja houve um aumento 150% na capacidade antioxidante no soro das mulheres e 200% no soro dos homens (p<0,001), mas não houve alteração na peroxidação lipídica no sangue dos voluntários. Concluindo, o aumento das reservas de flavanonas e de vitamina C, decorrente da ingestão regular de suco de laranja, melhorou expressivamente a capacidade antioxidante no sangue, sem, entretanto, apresentar efeito sobre a peroxidação lipídica.

Two biomarkers of oxidative stress were evaluated in healthy volunteers treated with daily doses of orange juice that is well known source of vitamin C and citric flavanones, which have been associated with antioxidant, anti-inflammatory and hypolipidemic effects. The antioxidant capacity in the blood serum was evaluated by studying the scavenging of 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical, and also lipid peroxidation was evaluated by the thiobarbituric acid reacting substances (TBARS) assay. The results have shown that the regular consumption of orange juice increased 150% and 200% the serum antioxidant capacity for women and men respectively, but it was no significant change in the serum lipid peroxidation. In conclusion, the increase of flavonones and vitamin C in the body due to the regular intake of orange juice expressively improved the antioxidant capacity, but without significant effect on the lipid peroxidation.

Effect of Ficus sycomorus and Azadirachta indica extracts on liver state of mice infected with Schistosoma mansoni

The potential role of hepatoprotective and antipathological effect of Ficus sycomorus and Azadirachta indica extracts was evaluated for scavenging the reactive oxygen species [ROS] and reduced the oxidative damage and pathological changes in the liver of S. mansoni infected mice. The levels of alanine aminotransferase [ALT], asparate aminotransferase [AST] and gamma glutamyl transferase [GGT] were evaluated in the infected mice and treated orally with each plant extract 12 weeks post infection [P.I.] in a dose of 500 mg/kg of each plant extract for five consecutive days and sacrificed two weeks P.I. The infection of mice showed an elevation of ALT, AST and GGT. Treatment of mice with 70% methanol extract of each plant extract reduced significantly ALT, AST and GGT elevation. The highest reduction was with the methanolic extract of F. sycomorus [42%, 35% and 44% for ALT, AST and GGT respectively]. Fractionation of the methanolic extract of each plant was carried out. The effect of ethyl acetate and butanolic fractions of each plant was also evaluated. The result showed that the two fractions lowered the levels of the tested enzymes and decreased the number and size of granuloma diameters with an increased in the percentage of degenerated ova

Null genetic risk of ACE gene polymorphisms with nephropathy in type 1 diabetes among Egyptian population

Reported to date, strong evidence exists in multiple studies for genetic predisposing in the development of diabetic nephropathy, and no studies addressed this issue among Egyptian population. The results of angiotensin converting enzyme gene [ACE] in the susceptibility to nephropathy in type 1 diabetes with nephropathy are conflicting. We aim to identify the associations of two ACE gene polymorphisms [PstI, A > G substitution and a 287-bp insertion/deletion] with nephropathy in type 1 diabetes in Egyptian children/adolescents. Our case-control study contained 140 diabetic individuals; 80 diabetic with nephropathy as cases, and 60 diabetic subjects without nephropathy as control group. Amplified DNA from peripheral leucocytes/buccal mucosa was genotyped for using polymerase chain reaction and enzymatic assay. We found no significant differences in the distribution of ACE insertion/deletion and PstI genotypes or allele frequencies were observed between the examined groups. Frequencies of PstI-indel haplotypes were similar in all of our study groups. In both cases and control subjects, ACE activity and microalbuminuria were highest among D/D homozygotes and lowest in I/I homozygotes, while a dissimilar result was seen in PstI polymorphism. Our findings in Egyptian population strongly conclude that there is no association between the ACE gene I/D and PstI polymorphisms with nephropathy in type 1 diabetes