Medical students' awareness of andcompliance with the hepatitis B vaccinein a tertiary care academic hospital: Anepidemiological study

Background: The hepatitis B virus [HBV] poses a health risk to healthcare workerswho are in close proximity to infected individuals. Medical students are a particularlyhigh-risk group due to the lack of an obligatory vaccination program and a post-vaccination screening program to determine immunity status, which results in alack of awareness of and compliance with the HBV vaccine

Methods: This cross-sectional survey was conducted in King Khalid University Hospi-tal [KKUH], a tertiary care academic hospital in Riyadh, Saudi Arabia, from November2013 to March 2014. Medical students in their second to fifth years [n = 444; 213 menand 231 women] completed a self-administered questionnaire regarding awarenessof HBV and compliance with the HBV vaccination program in KKUH

Results: Medium to low knowledge levels were present in 53.5% of the participants,and 44.3% reported that they were not compliant with the vaccination programprovided by KKUH. While 93.9% received the HBV vaccine upon entry to medicalschool, only 59.5% received all 3 doses, citing forgetfulness and a busy scheduleas common reasons for the low compliance. There was no association between theknowledge and awareness of the participants and their compliance [p = 0.988]

Conclusion: Medical students had a low level of compliance with the HBV vaccinationprogram, regardless of their knowledge and awareness of the disease and vaccination.We recommend that programs and campaigns be developed to increase the overallawareness of this disease. We also suggest that a mandatory HBV vaccination programshould be implemented to improve the compliance rate among medical students

role of endocannabinoids system in fatty liver disease and therapeutic potentials

Non-alcoholic fatty liver disease [NAFLD] is a major cause of liver morbidity and mortality with no proven effective therapy as of yet. Its prevalence is increasing globally in parallel with obesity and metabolic syndrome pandemic. The endocannabinoid [EC] system has been implicated in the pathogenesis of several diseases, including fatty liver diseases. This system refers to the cannabinoid receptors type 1 [CB1] and type 2 [CB2], with both their endogenous ligands and machinery dedicated to EC synthesis and degradation. There is accumulating evidence on the role CB1 as a key mediator of insulin resistance and liver lipogenesis in both animals and humans. On the other hand, CB2 receptors have been shown to promote inflammation with anti-fibrogenic properties. The pharmacological modulation of the EC system activity for the treatment of metabolic syndrome and NAFLD are promising yet premature. The initial limited success due to deleterious central nervous system side-effects are likely to be bypassed with the use of peripherally restricted drugs

Liver biopsy for histological assessment - the case in favor

Liver biopsy [LB] is the gold standard method for assessment of liver histology. It provides valuable, otherwise unobtainable information, regarding the degree of fibrosis, parenchymal integrity, degree and pattern of inflammation, bile duct status and deposition of materials and minerals in the liver. This information provides immense help in the diagnosis and prognostication of a variety of liver diseases. With careful selection of patients, and performance of the procedure appropriately, the complications become exceptionally rare in current clinical practice. Furthermore, the limitations of sampling error and inter-/intra-observer variability may be avoided by obtaining adequate tissue specimen and having it reviewed by and experienced liver pathologist. Current noninvasive tools are unqualified to replace LB in clinical practice in the face of specific limitations for each tool, compounded by a poorer performance towards the assessment of the degree of liver fibrosis, particularly for intermediate stages