ABSTRACT
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
ABSTRACT
Liver cirrhosis is associated with a wide range of cardiovascular abnormalities including hyperdynamic circulation, cirrhotic cardiomyopathy, and pulmonary vascular abnormalities. The pathogenic mechanisms of these cardiovascular changes are multifactorial and include neurohumoral and vascular dysregulations. Accumulating evidence suggests that cirrhosis-related cardiovascular abnormalities play a major role in the pathogenesis of multiple life-threatening complications including hepatorenal syndrome, ascites, spontaneous bacterial peritonitis, gastroesophageal varices, and hepatopulmonary syndrome. Treatment targeting the circulatory dysfunction in these patients may improve the short-syndrome. Treatment targeting the circulatory dysfunction in these patients may improve the short-term prognosis while awaiting liver transplantation. Careful fluid management in the immediate post-transplant period is extremely important to avoid cardiac-related complications. Liver transplantation results in correction of portal hypertension and reversal of all the pathophysiological mechanism that lead to the cardiovascular abnormalities, resulting in restoration of a normal circulation. The following is a review of the pathogenesis and clinical implications of the cardiovascular changes in cirrhosis