Comparison of students' performance in the traditional oral clinical examination and the objective structured clinical examination

To find out whether the objective structured clinical examination [OSCE] using standardized patients allows the same evaluation of students as the traditional oral clinical examination [TOCE] using real patients. The results of 4 cohorts of students [904 students] in the end of posting examination [using the TOCE], and the end of year examination [using OSCE] during the academic years 2003-2006 at King Abdulaziz University, Faculty of Medicine, Jeddah, Kingdom of saudi Arabia were analyzed retrospectively. Spearman's correlation coefficient was calculated for comparison of performance in the different parts of the 2 examinations. There was a strong positive correlation between the results of the OSCE and the final grade of the students [r = 0.786], and between the TOCE and the final grade of the students [r=0.591]. The coefficient for correlation between the results of the OSCE and TOCE was 0.406. The OSCE can be used for the evaluation of clinical skills like the TOCE with better objectivity and reliability

Serosurvey of measles, mumps and rubella antibodies in Saudi children

A serosurvey study to evaluate the proportion of children with antibodies against diseases targeted by the Expanded Program of Immunization in the Kingdom of Saudi Arabia. Using multistage sampling techniques, we collected samples and sent them for laboratory assay from the following age groups; 100 samples at 6 months, 12 months, 18 months, 6 years, 13 years, and 17 years. We conducted the study from September 2001 to February 2002. We assayed sera for measles, rubella, and mumps antibodies in the measles-mumps-rubella reference laboratory in Germany, using enzyme immunoassay and plaque neutralization [PN] as a backup test for equivocal and negative samples. We only carried out a backup test for measles samples. The age group of 6 months had the highest proportion with negative measles antibodies. After adding the backup test [PN], the proportions of children with protective measles antibody were; 64% at 6 months, 87% at 12 months, 91% at 18 months, 75% at 6 years, 96% at 13 years, and 98% at 17 years. Rubella antibody positivity rates [>7 IU] were 28% at 6 months, 49% at 12 months, 97% at 18 months, 98% at 6 years, and 100% at 13 years. While positivity rates in mumps were 14% at 6 months, 29% at 12 months, 59% at 18 months, 64% at 6 years, and 75% at 13 years. The unexpected low proportion of children with protective level at 6 years, despite being vaccinated with 2 measle doses is an important phenomenon. This reflects the interference between the first and the second measles dose. The Ministry of Health decided to conduct a catch up campaign targeting 1st through 3rd grade primary schools, who did not catch the mass campaign conducted in 2000. Also, this supports the decision taken by the ministry to change the measles immunization schedule to MMR at 12 months and a second dose at 6 years of age

Serosurvey of hepatitis B surface antigen in pregnant Saudi women

In 1990, Saudi Arabia began vaccinating all children at school entry against hepatitis B. We evaluated hepatitis B surface antigen [HBsAg] prevalence rate among pregnant Saudi women 12 years later in 5 regions of the country. Using multistage sampling, 2664 pregnant Saudi women were recruited. Blood samples were tested for HBsAg; positive samples were also tested for hepatitis Be antigen [HBeAg]. In all 2.44% were positive for HBsAg and 4 [0.15%] were also positive for HBeAg. HBsAg prevalence was highest in Gizan [4.2%] and lowest in Tabuk [1.4%]. Positivity for women < or = 20 years of age was 0.5% compared with 2.6% for older women [P = 0.049]. The overall HBsAg prevalence rate was lower than previously reported

Thoracic actinomycosis presented with tracheoesophageal fistula and fatal pulmonary infection

We report a case of a 60-year-old Saudi woman who developed tracheoesophageal fistula and fatal pulmonary infection secondary to thoracic actinomycosis. The cause, clinical presentation, radiological features and treatment of thoracic actinomycosis are discussed

rare metastasis from Hepatocellular carcinoma

Primary hepatocellular carcinoma is the second most common gastrointestinal cancer [GIT] in the Kingdom Skin metastasis occur mainly in advanced cases. Using Medline Search only 48 cases of skin metastasis from hepatocellular carcinoma have been reported in the world literature in the past 10 years, with no report from Saudi Arabia

Macroscopic intrahepatic foreign body

A 55-year-old woman presented to the surgical out-patients clinic with an epigastric hernia. During routine investigations, her chest X-ray showed a sewing needle projecting to her epigastric area. Intraoperatively, the needle was found to be in the liver. The English literature is reviewed