Didymin protects against polystyrene nanoplastic-induced hepatic damage in male albino rats by modulation of Nrf-2/Keap-1 pathway

Polystyrene nanoplastics (PS-NPs) are ubiquitous environmental pollutants that can cause oxidative stress in various organs, including the liver. Didymin is a dietary flavanone that displays multiple pharmacological activities. Therefore, the present study evaluated the palliative role of didymin against PS-NPs-induced hepatic damage in rats. Albino rats (n=48) were randomly distributed into 4 groups: control, PS-NPs treated group, PS-NPs + didymin co-administered group, and didymin supplemented group. After 30 days, PS-NPs intoxication lowered the expression of Nrf-2 and anti-oxidant genes [catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione reductase (GSR), glutathione-S-transferase (GST), and heme oxygenase-1 (HO-1)], whereas the expression of KEAP1 kelch like ECH associated protein 1 (Keap-1) was increased. PS-NPs exposure also reduced the activities of anti-oxidants enzymes (CAT, SOD, GPx, GSR, GST, GSH, and OH-1), while malondialdehyde (MDA) and reactive oxygen species (ROS) levels were increased. The levels of alanine transaminase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP) were increased in PS-NPs-exposed rats. Moreover, inflammatory indices [interleukin-1β (IL-1β), tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), nuclear factor-kappa B (NF-κB), and cyclooxygenase-2 (COX-2)] were increased in PS-NPs-exposed rats. Furthermore, PS-NPs intoxication increased the expressions of apoptotic markers including Bax and Caspase-3, as well as reducing Bcl-2 expression. The histopathological analysis showed significant damage in PS-NPs-treated rats. However, didymin supplementation ameliorated all the PS-NPs-induced damage in the liver of rats. Therefore, it was concluded that didymin can act as a remedy against PS-NPs-induced liver toxicity due to its anti-apoptotic, anti-oxidant, and anti-inflammatory activities.

Faculty attitudes toward teaching students with mild intellectual disabilities in higher education / Atitudes do corpo docente em relação ao ensino de alunos com deficiência intelectual leve no ensino superior

ABSTRACT The purpose of this study was to examine the relations between faculty members' attitudes in Higher Education Saudi universities and demographic factors (i.e., academic rank, gender, years of experience, and type of college) by using the Interaction with Disabled Persons (IDP) Scale and multiple regression analysis. Results indicate that gender was associated with one dimension: vulnerability. The ranks of assistant professor and full professor were related to two dimensions: discomfort in social interactions and a coping-succumbing framework. Also, the college education variable was related to three dimensions: discomfort in social interactions, perceived level of information, and vulnerability. Results show that faculty members had lower negative attitudes toward students with mild intellectual disabilities in Higher Education. Based on study results, the researcher recommends more faculty training in how to support the Higher Education of students with disabilities as well as accessible support centers for individuals with disabilities to help staff as well as students. Also, universities should be made accessible to people with all types of disabilities who have a right to Higher Education.

RESUMO O objetivo deste estudo foi examinar as relações entre as atitudes dos membros do corpo docente no Ensino Superior de universidades sauditas e os fatores demográficos (ou seja, classificação acadêmica, gênero, anos de experiência e tipo de faculdade) usando a Escala de Interação com Pessoas com Deficiência (IPD) e a análise de regressão múltipla. Os resultados indicam que o gênero estava associado a uma dimensão: vulnerabilidade. As posições de professor assistente e professor titular estavam relacionadas a duas dimensões: desconforto nas interações sociais e uma estrutura de enfrentar-sucumbir. Além disso, a variável educação universitária estava relacionada a três dimensões: desconforto nas interações sociais, nível percebido de informação e vulnerabilidade. Os resultados mostram que os membros do corpo docente tiveram atitudes negativas mais baixas em relação aos estudantes com deficiências intelectuais leves no Ensino Superior. Com base nos resultados do estudo, o pesquisador recomenda mais treinamento do corpo docente sobre como apoiar os estudantes com deficiência no Ensino Superior bem como centros de suporte acessíveis para indivíduos com deficiência para ajudar a equipe e os alunos. Ademais, as universidades devem ser acessíveis a pessoas com todos os tipos de deficiência que têm direito ao Ensino Superior.

Prevalence, impact, and management perception of dysmenorrhea among university students: A cross-sectional study

Abstract Dysmenorrhea is a common condition among females that is characterized by painful cramps before or during menstruation. It is considered as a common gynecological complaint that affects the quality of women's life. The study evaluated prevalence of dysmenorrhea, its impact, associated risk factors, and the management strategies adopted by female university students in Taif city, Saudi Arabia. A cross-sectional study was conducted among 562 female students aged 18-30 years at the university level. The results showed a high prevalence rate of dysmenorrhea (79.4%) among the students. The most common risk factors were family history (87.4%) and length of menstruation (79%). Half (50.2%) of the respondents were absent at the university at least 1 day every month. The most widely used medications by the respondents were ibuprofen (42%) and paracetamol (40%), whereas only 3% used mefenamic acid, despite that they experienced complete pain relief with mefenamic acid. High prevalence rate of dysmenorrhea associated with risk factors such as family history and length of menstruation, was found among university students. However, pain and associated symptoms affect the quality of life.

Awareness about vulvovaginal aesthetics procedures among medical students and health professionals in saudi arabia

Abstract Objective The present study aimed to explore the opinion and ethical consideration of vulvovaginal aesthetics procedures (VVAPs) among health professionals and medical students in Saudi Arabia. Methods This is a cross-sectional study performed between January 2020 and April 2020. Data was collected through electronic media, WhatsApp, and emails. The results were analyzed by applying the Students t-test, and correlations were considered significant if they presented a p-value<0.05. Results There is significant demand to educate doctors, health professionals, medical students, and gynecologists for the VVAPs to have a solid foundation, justified indications, and knowledge about various aesthetic options. Although female doctors, medical students, young doctors, and gynecologists have more knowledge about VVAPs, all health professionals ought to be aware of recent trends in vulvovaginal aesthetics (VVA). The present analysis determined that VVA should be under the domain of gynecologists, rather than under that of plastic surgeons, general surgeons, and cosmetologists. Themajority of the participants considered that vaginal rejuvenation, "G-spot" augmentation, clitoral surgery, and hymenoplasty are not justifiable on medical grounds. Conclusion The decision to opt for different techniques for vaginal tightening and revitalization should be taken very carefully, utilizing the shared decision-making approach. Ethical aspects and moral considerations are important key factors before embarking in the VVAPs purely for cosmetic reasons. Further research is required to determine the sexual, psychological, and body image outcomes for women who underwent elective VVAPs. Moreover, medical educators must consider VVAPs as part of the undergraduate and postgraduate medical curriculum.

The Top-100 most cited articles on dural arteriovenous fistula: A bibliometric analysis

Objective@#Dural arteriovenous fistula (DAVF) is a rare pathological vascular lesion with variable clinical manifestations. Since 1968, several articles have been published to address spinal and cranial DAVFs. The aim of this study is to identify, analyse, and review the pertinent literature of the top-100 most cited articles on DAVFs published to date. @*Methods@#A title-specific, keyword-based search with no time restriction was performed in June 2020. The Scopus database was used to identify the top-100 most cited articles on DAVFs. The term “dural arteriovenous fistula” was used as a search keyword. The search results were arranged in descending order based on the total citation count. The top-100 articles were categorized into ten categories. @*Results@#Between 1968 and 2020, a total of 2298 articles were published on DAVFs. The top-100 most cited articles were published between 1983 and 2012. The total number of citations for the top-100 articles was 12393 (123 citations/article). Most articles (34%) were investigating the clinical aspect of DAVFs. The country contributing to the most impactful and highest volume of publications (46%) was the United States. The Mayo Clinic was the most active institute in contribution. Most articles (29%) were published by the Journal of Neurosurgery. @*Conclusions@#In the top-100 most cited articles on DAVF, most studies were published in neurosurgeryeuroradiology-dedicated journals. This bibliometric analysis identifies the publication trends and provides a comprehensive overview of the most influential articles addressing DAVFs.

The Top-100 most cited articles on Moyamoya disease: A bibliometric analysis

Objective@#Moyamoya disease (MMD) is a progressive steno-occlusive cerebrovascular phenomenon with unknown pathogenesis. Considering the abundance of articles addressing Moyamoya disease, a detailed analysis concerning the publication trends is of paramount importance. The aim of the study is to report the current knowledge of the top-100 most cited articles on Moyamoya disease in the literature. @*Methods@#A non-time restricted keyword-based search was performed in June 2020 using the Scopus database. The search keywords included the following: “Moyamoya”, “Moyamoya disease”, and “Moyamoya syndrome”. The search result was used to rank the articles based on their citation count. The top-100 most-cited articles were obtained and classified into seven categories. @*Results@#A total of 3,543 articles on Moyamoya disease were published between 1955 and 2020. The Top-100 articles were published between 1977 and 2016 with a total of 16,119 citations, per year, and 7.23% rate of self-citation. The 1990s was the most productive decade (N=42). The most contributing country to the list was Japan (N=60). Stroke was the most active journal (N=23). Houkin, K., a Japanese neurosurgeon, was the most prolific author (N=15). @*Conclusions@#Moyamoya disease has been extensively investigated in the literature throughout the years. The majority of articles published in the literature were addressing the surgical management and clinical outcome. Authors from neurosurgical backgrounds were the most active contributors to the field of Moyamoya disease.

A bibliometric analysis on the most-cited publications on carotid endarterectomy throughout history

Objective@#Carotid endarterectomy (CEA) is the gold standard surgical procedure for managing carotid stenosis due to atherosclerosis and reducing the risk of ischemic stroke. This bibliometric analysis summarizes the most-cited articles on CEA and highlights the contributing articles to today’s evidence-based practice. @*Methods@#A title-specific search using the Scopus database was used to perform the search. Pertinent article-based, journal-based, and author-based parameters were obtained for review. @*Results@#A total of 6,824 articles were published between 1970 and 2020. The top 100 most-cited articles accumulated a total of 54,153 citations with an average citation count (CC) of 541, with only a 4.53% self-citation rate for all authors. The publication trends peaked between 1997 and 2010, in which two-third of the highly cited works were published. The most prolific categories with top citations are the clinical, indications, and management, in a descending order. There were 41 published Randomized Controlled Trials (RCT) in the most-cited list. @*Conclusions@#Citation analysis on carotid endarterectomy has witnessed a marked shift in the publication trends from studying the outcome and complications to comparing carotid stenting with endarterectomy. This analysis is a good introductory article to physicians interested in this topic, as it summarizes the highly impactful articles and enlists the most-cited RCT on CEA.

The Top-100 most cited articles on dural arteriovenous fistula: A bibliometric analysis

Objective@#Dural arteriovenous fistula (DAVF) is a rare pathological vascular lesion with variable clinical manifestations. Since 1968, several articles have been published to address spinal and cranial DAVFs. The aim of this study is to identify, analyse, and review the pertinent literature of the top-100 most cited articles on DAVFs published to date. @*Methods@#A title-specific, keyword-based search with no time restriction was performed in June 2020. The Scopus database was used to identify the top-100 most cited articles on DAVFs. The term “dural arteriovenous fistula” was used as a search keyword. The search results were arranged in descending order based on the total citation count. The top-100 articles were categorized into ten categories. @*Results@#Between 1968 and 2020, a total of 2298 articles were published on DAVFs. The top-100 most cited articles were published between 1983 and 2012. The total number of citations for the top-100 articles was 12393 (123 citations/article). Most articles (34%) were investigating the clinical aspect of DAVFs. The country contributing to the most impactful and highest volume of publications (46%) was the United States. The Mayo Clinic was the most active institute in contribution. Most articles (29%) were published by the Journal of Neurosurgery. @*Conclusions@#In the top-100 most cited articles on DAVF, most studies were published in neurosurgeryeuroradiology-dedicated journals. This bibliometric analysis identifies the publication trends and provides a comprehensive overview of the most influential articles addressing DAVFs.

The Top-100 most cited articles on Moyamoya disease: A bibliometric analysis

Objective@#Moyamoya disease (MMD) is a progressive steno-occlusive cerebrovascular phenomenon with unknown pathogenesis. Considering the abundance of articles addressing Moyamoya disease, a detailed analysis concerning the publication trends is of paramount importance. The aim of the study is to report the current knowledge of the top-100 most cited articles on Moyamoya disease in the literature. @*Methods@#A non-time restricted keyword-based search was performed in June 2020 using the Scopus database. The search keywords included the following: “Moyamoya”, “Moyamoya disease”, and “Moyamoya syndrome”. The search result was used to rank the articles based on their citation count. The top-100 most-cited articles were obtained and classified into seven categories. @*Results@#A total of 3,543 articles on Moyamoya disease were published between 1955 and 2020. The Top-100 articles were published between 1977 and 2016 with a total of 16,119 citations, per year, and 7.23% rate of self-citation. The 1990s was the most productive decade (N=42). The most contributing country to the list was Japan (N=60). Stroke was the most active journal (N=23). Houkin, K., a Japanese neurosurgeon, was the most prolific author (N=15). @*Conclusions@#Moyamoya disease has been extensively investigated in the literature throughout the years. The majority of articles published in the literature were addressing the surgical management and clinical outcome. Authors from neurosurgical backgrounds were the most active contributors to the field of Moyamoya disease.

Needs And Utilization Of Drug-Information Resources Of Healthcare Providers In An Academic Tertiary Care Center

Objective: To investigate the drug-related information needs of healthcare providers (HCPs), their utilization of drug information resources as well as the main factors influencing the selection of resources. Methods: A total of 393 HCPs were conveniently selected and invited to complete a questionnaire. Stratified sampling was used for the three subpopulations of physicians, pharmacists, and nurses. The questionnaire was coded, validated, and analyzed using the Statistical Package for the Social Sciences (SAS version 9.2). Results: Of 450 HCPs approached, 393 completed the questionnaire (response rate 87%). Information related to drug dosage/administration, indications, and interactions is the most frequently required, 47%, 44%, and 34%, respectively. The majority of the sample perceived the Internet (69.47%) and electronic databases (67.43%) as “very useful.” Printed materials (46.56%) and Personal Digital Assistants (PDAs) (44.78%) or calling the pharmacy (43.26%) were also useful resources of information followed by using electronic books and journals (38.42%) and asking colleagues (32.32%). The majority (53.18%) described consulting a clinical pharmacist as “very useful.” However, 16% of the nurse group and 35% of the physician group were not aware of the existence of the Drug Information Center (DIC) and more than 8% of the participants consider calling the DIC about drug-related information “not useful”. Conclusion: Digital resources are used by HCPs more frequently than traditional resources, consulting a clinical pharmacist or calling the DIC. Providing reliable electronic resources and raising the awareness of HCPs regarding the role of a clinical pharmacist and DIC for patient-specific therapies should be instituted.

Association between Vitamin D Deficiency and High or Low Energy Fractures among Patients above 45 Years Old in Riyadh

Background: An essential element in the equilibrium of calcium in the body is Vitamin D. It prompts adding calcium into the circulation. As a result, it could have a significant role in preventing the occurrence of high and low energy fractures. The point of this study was to find an association of Vitamin D deficiency with low or high energy fractures among patients older than 45 years old in King Abdulaziz Medical City in Riyadh. Method: This was a retrospective cross-sectional study that was conducted from January 2015 to December 2017 at the Orthopedic department in KAMC-Riyadh. A total of 230 Saudi fracture patients older than 45 years old with measured Vitamin D levels were reviewed. The variables included age, gender, 25-hydroxyvitamin D level, and type of fracture; high vs. low-energy fracture. The deficiency was considered as serum concentrations of 25(OH)D<50 nmol/L. Results: There was a high prevalence of 25-hydroxyvitamin D deficiency 25(OH)D<50 nmol/L in (62%) among the study sample. This study found no association between 25-hydroxyvitamin D deficiency with fracture type (p=0.75) with high energy fractures (63%, 66/105) vs. low energy fractures (61%, 76/125), respectively. Conclusion: In spite of the high prevalence of deficiency within all fracture patients, these results are comparable to previous studies on the normal non-fracture population. More studies are required to look into more factors that might increase the probability of fractures..

Literature Review on Prevalence, Risk Factors and, Evaluation of Acute Lower Back Pain

Background: Acute back pain is any pain located at the back that lasts for less than 4 weeks duration. Theprevalence is fair with as many as 84% of the adult population around the globe experience back pain at somepoint in life and is often self-limiting. However, in few selected patients it may serve as indicator of a seriousunderlying disease making it crucial to properly evaluate, characterize and address this concern. Objectives: Inthis review we intend to explore the prevalence, risk factors and highlight the available methods using diagnosticimaging modalities to evaluate and address this condition. Materials and Methods: A review of relevant articlespublished from 1987 onwards in English language was done using the electronic databases of PubMed Pico and,Google Scholar with preset keywords. Conclusion: Acute back pain prevalence range between 22 to 48 percentand risk factors are non-modifiable such as advanced age and female gender while modifiable risk factors areobesity, smoking, low education, sedentary lifestyle, etc. Employment related factors such as physically strenuouswork also increase the risk of developing back pain. Notably, under-appreciated risk factors includingpsychological risk factors such as anxiety should be screened for while evaluating patients. Evaluation of backpain mostly relies on comprehensive history and physical examination, as most cases are self-limited. Diagnosticimaging is only recommended in cases presenting with red flag symptoms.

Liver Trauma Diagnosis and Surgical Management

Background: Liver trauma is one of the most common affected organs in blunt abdominal trauma. It is associatedwith a high rate of morbidity and mortality. Therefore, choosing the best modality for diagnosis and managingsuch high-risk patients is crucial. Objectives: In this study, we aim to review the literature focused on mechanismof liver trauma, pathophysiology, risk factors, diagnosis, and management with a focus on surgical approach.Methodology: PubMed database was used for articles selection using the following keywords: liver injury, andits management, and evaluation. Conclusion: Management of liver trauma patients depends on their status duringthe general assessment of the case. In hemodynamically unstable patients and those with gun-shot wounds, thefirst line is surgery. However, non-operative management remains the mainstay of therapy in blunt liver injury.The main rule dictating this decision is hemodynamic stability. Certain factors increase the risk of failedconservative therapy, and these should alert the surgeon to the possibility of conversion to the surgicalintervention.

Diabetic Retinopathy Knowledge, Awareness and Practices of Physicians in Primary Health Care Centers

Purpose: Diabetes retinopathy (DR) is one of the fatal causes of permanent and irreversible blindnessinfection that is prevalent making individuals suffer from diabetic conditions; however, annual medicalexamination is a critical interventional approach that not only limits the extent of infection but aids in timelyformulation of relevant mitigation strategies and control of DR. Common to other healthcare systems inadvance economies, the primary care physicians (PCP) are the immediate providers of primary care fordiabetes across the kingdom of Saudi Arabia (KSA). The aim of the present research paper is to assess thecurrent awareness, practices, and knowledge of PCP on DR. Method: The present research adopted a crosssectional design that covered three cities in Saudi Arabia. A self-administered questionnaire with threedifferent parts was submitted to physicians in the healthcare facilities across the three cities. In addition, theresearch adopted a convenience sampling method during which the designated regions were selected due toconvenience in proximity as well as accessibility. Results: The research paper considered a sample size of710 participants. An in-depth and compressive analysis of the results elucidated underlying defects as well asshortfalls on the physicians’ awareness, knowledge, and practices on DR. The results demonstrated defects inscreening methods as well as referral procedures among physicians. Conclusion: Overall, the extent ofknowledge, practices, and awareness among the PCP in the three cities were satisfactory. Hence, it is highlyrecommended that future awareness campaigns should focus on timely and detailed screening approaches inorder to manage diabetic conditions among patients.

Review of Knowledge, Attitude, and Practice Among Laboratory Workers Towards Occupational Safety and Health

@#Laboratory workers exposed to diverse occupational exposures to accidents. Evidently, extant, yet very limited empirical underpinnings suggest that knowledge, practices and awareness of safety precautions are uncharacteristically poor among laboratory workers. As such, their demonstration of safety-related attitudes and practices have remained questionable. This paper, thus presents a systematic search of the literature on laboratory workers’ safety-related knowledge, attitudes, and practices. Specifically, literature published between 2007 and 2017 that characteristically attempted to evaluate knowledge, attitudes and practices among laboratory workers on Occupational Safety and Health were reviewed. Evidently, results from the review indicate poor knowledge, attitude and practice among the laboratory workers. It is critical that strategies be put in place by the management of the health facilities to institute and undertake activities in the form of training, improved safety management practices, organizational commitment and improved safety culture.

Utility of Procalcitonin Test in Appropriate Antibacterial Choice: Retrospective Evaluation

Background: Procalcitonin testing (PCT) demonstrates its effectiveness for specifically diagnosing bacterial infections, as it is elevated in bacterial infections but not viral infections. Its clinical usefulness has been shown with antibiotic selection for different infections. Methods: This retrospective observational study aims to evaluate PCT test clinical utility in reducing the use of antibiotics, and the length of hospital stays. The study conducted at a tertiary hospital in Riyadh, Saudi Arabia included a total of 660 patients who were ordered procalcitonin test. Results: Subjects were grouped according to PCT level. All patients with PCT level ≥ 0.1 ng/ml (n=457) are qualified to receive antibiotic treatments. A total of 75.7% were prescribed antibiotics. The length of hospital stay (LOS) in patients who received antibiotics was statistically significantly higher than patients who did not receive any antibiotics (LOS 32.7 vs. 65.1 days, p-value=0.01). However all patients with PCT level <0.1ng/mL (n=203) show no statistically significant difference in the length of stay at hospital among patients who were prescribed an antibiotic or not (p-value=0.64). Only 31% of this group has inappropriately prescribed an antibiotic. Another infection precursor-like WBC count was also evaluated with no significant differences among groups. Conclusion: This study showed that the utilization of PCT guided antibiotic prescribing reduces the length of stay and reduces antibiotic use. PCT guided antibiotic prescribing can be utilized efficiently in hospital settings.

Patterns and Clinical Characteristics of Traumatic Spine Fractures in Taif, Saudi Arabia: A Retrospective Study

Background: Traumatic spine injury plays a major rule in morbidity and mortality worldwide and can result in severe and permanent disabilities which has a huge impact on patients and their families due to the change in quality of their lifestyle and the high cost of treatment is considered a burden on individuals and families as well as the health care system. Methodology: Data were acquired retrospectively from King Abdul-Aziz Specialist Hospital and King Faisal Medical Complex medical records within June 2014 and June 2018. Results: A total of 151 patients were identified with a mean age of 35.36 ± 16.20 and 78.1% were males. MVA caused 71.3% of the documented spine injuries with meals being significantly affected compared to females followed by fall down 23.3%. No significant relationship was found between the patients’ age and the mechanism of trauma. 21.2% had multiple fractured vertebrae along with multiple levels, while 28.5%, 27.2% and 23.2% had fractures in the cervical, thoracic and lumbar regions, respectively. 16.6% of patients sustained neurological deficits, 10% had a GCS less than 13 and 18.5% had multiple associated injuries followed by chest 10.5%, Pelvic 5.6%, Head 4.8% and facial 3.2% Injuries. 34.5% had a vertebral body fracture and 14.8% had a spinal cord injury. 72.5% were managed conservatively while 27.5% underwent surgery within a mean of 5.47 ± 7.24 days. 13.2% received steroid which significantly led to a longer hospital stay (14.55 ± 12.67 vs. 9.11 ± 12.51). Patients were hospitalized for 8.06 ± 10.05 days and 22.8% needed an ICU admission for 1.78 ± 6.05 days and those who had spinal cord contusion had a longer LOHS compared to other types of injuries. During the period of hospitalization, 5.29% experienced complications. Conclusion: MVA was the leading cause of traumatic spine injuries and their consequences on patients’ health irrespective of their age and nationalities which necessitate initiating prevention measures.

Utilization of Social Media in Educating Family Medicine Residents in the Kingdom of Saudi Arabia: Frequency and Belief

Background: Social media may offer certain advantages over more traditional educational tools as they can be accessed geographically and temporally in asynchronous manners as well as the majority of young health professionals prefer online media as their primary source of information. Objectives: To explore the frequency of use and belief of family medicine residents all over the Kingdom regarding the utilization of social media in learning. Subjects and methods: Cross-sectional study was carried out January to October 2019 in all Regions of the Kingdom of Saudi Arabia (KSA) that hosts a postgraduate training program. A sample of family medicine residents enrolled in all family Medicine residency programs of the Saudi Commission of Health Specialists (R1-R4) was chosen. Data were collected using an online questionnaire consists of four main parts: personal characteristics of the residents, details of SM utilization in education belief concerning the impact of utilization of SM on learning and barriers and problems faced in using SM in education. Results: The study included three hundred family medicine residents. Females represent 56.7% of them. The majority of them (93%) reported using social media in education. Almost one-third of the participants (36.6%) reported daily use of social media in education. The commonest used social media in education was YouTube (73%), followed by Google+ (32.3%) and Twitter (14.3%). Overall, the percentage of the belief regarding the impact of SM on learning scores among family medicine residents ranged between 36.2% and 100% with a mean ± SD of 72.1 ± 13 and median (IQR) of 74.5% 963.8-80.9%). More than half of the family medicine residents (51%) reported non-communication with their tutor via social network. Nearly one-third of the family medicine residents (36%) reported institutional non-usage of social media in education. Only 39.1% of family medicine residents were aware of the ethical guidance for using social media. Conclusion: The use of social media among family medicine residents in Saudi Arabia in medical education is very common, with no difference according to gender, residency level or place of the residency program. However, an apparent confusion was observed concerning the belief of family medicine residents towards the influence of utilizing social media in learning.

Assessment of Community-Based Home Health Programs among Children with Chronic Disease in Tertiary Care Center, Riyadh

Background: Home health care (HHC) is a newly developed model of care that helps patients to be treated at their home and avoid hospital admission with the aim of promoting, maintaining or restoring health as part of their comprehensive services. Objective: To assess the effectiveness of HHC in reducing the days of admissions and ED visits for children with chronic diseases. Materials and methods: A cross-sectional study held at a tertiary care center. Consecutive sampling technique was used to review all patients’ files registered for HHC program from 2016 to 2018. Continuous variables were reported as mean and standard deviation, whereas categorical were reported as percentages and frequencies. Wilcoxon rank test was used to assess differences before and after enrolment in the HHC program. SPSS V22.0 was used for analysis. Results: A total of 92 patients were involved in this study; 57% were males and 44% were females. 42% of them had neurodevelopmental diseases. Among all the services provided, nursing care was the most needed service. The total number of days of admission was reduced from 28 ± 0.6 to 6.75 ± 0.39 days in 4 months period and from 38.37 ± 62 to 9.02 ± 14 days in 6 months period with p-value<0.001. However, the ED visits were not affected by the p-value of 0.19 and 0.33 for both 4 months and 6 months period, respectively. Conclusion: HHC program showed an effective result in reducing the frequency of hospital admission and days of children’s admission, yet it had no effect on lowering the ED visits.

Risk Factors of Chemotherapy-Induced Neutropenia associated with FOLFOX, FOLFIRI, and FOLFOXIRI Regimens used in Patients with Advanced and Metastatic Colorectal Cancer

Background: Since the introduction of oxaliplatin and irinotecan, they have been the mainstay chemotherapies in the fluorouracil-based regimens, FOLFOX, FOLFIRI, and FOLFOXIRI, used in the treatment of advanced and/or metastatic colorectal cancer (CRC). These regimens are effective and usually well-tolerated in patients. However, they have been associated with neutropenia in some patients. Objective: The aim of this study was to assess risk factors of chemotherapy-induced neutropenia associated with the regimens used in CRC patients. Methods: A retrospective analysis was conducted of all CRC patients’ records who had been treated with the aforementioned regimens between January 2016 and February 2019 at the oncology clinics in a tertiary referral hospital in Riyadh, Saudi Arabia. Results: A total of 136 patients treated with the standard CRC regimens were identified. The majority of CRC patients (63.2%) had stage IV with extensive metastases. Twenty-two patients (16.2%) had developed neutropenia. However, only 13 of the neutropenic patients (59.1%) had shown symptoms of infections or fever. Most neutropenia occurred between the third and the fourth cycle of the used regimen. A significant increase in neutropenia was found in females (p=0.0273) and in patients with stage IV (p=0.0378). However, 53 CRC patients (39.0%) who received filgrastim had shown a significantly lower incidence of neutropenia (p=0.0027). Conclusion: Despite the effectiveness of the CRC chemotherapy regimens, the risk of neutropenia is still considerably elevated. The use of granulocyte colonystimulating factors such as filgrastim is an effective intervention to reduce neutropenia, hence infections, in high-risk CRC patients