Similarities and variances in perception of professionalism among Saudi and Egyptian Medical Students

Background and Objective: Professionalism has a number of culturally specific elements, therefore, it is imperative to identify areas of congruence and variations in the behaviors in which professionalism is understood in different countries. This study aimed to explore and compare the recommendation of sanctions by medical students of College of Medicine, King Saud University [KSU], Riyadh, Saudi Arabia and students from three medical colleges in Egypt

Methods: The responses were recorded using an anonymous, self-administered survey "Dundee Polyprofessionalism Inventory I: Academic Integrity". In the study 750 medical students of College of Medicine, KSU, Riyadh were invited and a questionnaire was electronically sent. They rated the importance of professionalism lapses by choosing from a hierarchical menu of sanctions for first time lapses with no justifying circumstances. These responses were compared with published data from 219 students from three medical schools in Egypt

Results: We found variance for 23 [76.66%] behaviors such as "physically assaulting a university employee or student" and "plagiarizing work from a fellow student or publications/internet". We also found similarities for 7 [23.33%] behaviors including "lack of punctuality for classes" and drinking alcohol over lunch and interviewing a patient in the afternoon", when comparing the median recommended sanctions from medical students in Saudi Arabia and Egypt

Conclusion: There are more variances than congruence regarding perceptions of professionalism between the two cohorts. The students at KSU were also found to recommend the sanction of "ignore" for a behavior, a response, which otherwise was absent from Egyptian cohort

Distribution of clinical symptoms in carpal tunnel syndrome

To determine the distribution of clinical symptoms based on the gender and age of patients with Carpel Tunnel Syndrome [CTS]. A cross-sectional observational study. Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia, from April 2009 to June 2011. Two hundred and twenty seven subjects with carpal tunnel syndrome symptom were recruited. CTS was diagnosed based on the clinical history and examination. For further confirmation of CTS symptoms, nerve conduction studies [NCS] were conducted. There were 67 [29.5%] males and 160 [70.5%] females with mean age of 47.79 A +/- 5.53 years. Distributions of symptoms were 34.3% at the level of whole three lateral fingers, 14.9% were at the level of hand and forearm, was common in males compared to females. However, 48.8% symptoms at the level of whole hand, and 11.3% at the tips of the three lateral fingers were common in females compared to males. Distribution of symptoms in the whole three lateral fingers [41.6%] were significantly higher [p = 0.0001] in patients who were more than 50 years of age and symptoms at the level of wrist region [12.7%] were significantly higher [p = 0.001] in patients with age group less than 50 years. The distribution of CTS symptoms at the level of whole of three lateral fingers, hand and forearm were higher in males compared to females, and symptoms at the lateral three tips of the fingers and whole hand were common in females compared to males. Furthermore, the symptoms in whole three lateral fingers were higher in patients with more than 50 years of age and at the level of wrist region were higher in patients with age less than 50 years

Wound healing without drains in posterior spinal fusion in idiopathic scoliosis

To determine the frequency of wound infection and neurological injuries in patients with idiopathic scoliosis who underwent posterior spinal fusion without use of drains. Case series. Department of Orthopaedics, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from February 2007 to June 2010. Patients who underwent similar technique of posterior spinal fusion instrumentation for the correction of scoliosis without use of drain were included. Wound Demographics, wound healing, complications and duration of hospital stay were considered and described as frequency and mean values. The average age at the time of surgery was 12.80 +/- 1.30 years, duration of surgery was 3.80 +/- 0.86 hours, hospital stay was 3.84 +/- 0.78 days and patients were followed-up over the last 30 months. There was no incidence of any neurological complication and deep infection. However, only 2 [4.16%] cases with superficial skin infection were treated with dressing and antibiotics with full recovery. The wound healing is adequate without using drain for patients with idiopathic scoliosis who underwent posterior spinal fusion and instrumentation when good wash, watertight closure technique and appropriate antibiotics coverage is provided

Basic steps in establishing effective small group teaching sessions in medical schools

Small-group teaching and learning has achieved an admirable position in medical education and has become more popular as a means of encouraging the students in their studies and enhance the process of deep learning. The main characteristics of small group teaching are active involvement of the learners in entire learning cycle and well defined task orientation with achievable specific aims and objectives in a given time period. The essential components in the development of an ideal small group teaching and learning sessions are preliminary considerations at departmental and institutional level including educational strategies, group composition, physical environment, existing resources, diagnosis of the needs, formulation of the objectives and suitable teaching outline. Small group teaching increases the student interest, teamwork ability, retention of knowledge and skills, enhance transfer of concepts to innovative issues, and improve the self-directed learning. It develops self-motivation, investigating the issues, allows the student to test their thinking and higher-order activities. It also facilitates an adult style of learning, acceptance of personal responsibility for own progress. Moreover, it enhances student-faculty and peer-peer interaction, improves communication skills and provides opportunity to share the responsibility and clarify the points of bafflement

Work-Related musculoskeletal symptoms among building construction workers in Riyadh, Saudi Arabia

To investigate the work-related musculoskeletal symptoms among building construction workers. Total 389 apparently healthy, male volunteers were selected with mean age 34.56_8.33 years and a mean working duration in building construction as 5.76 +/- 2.68 years. Musculoskeletal complaints were recorded through a detailed clinical interview and comprehensive questionnaire. Substantial number of building construction workers developed musculoskeletal symptoms including neck pain 29 [7.5%], shoulder pain 41[10.5%], upper back pain 24[6.2%], lower back pain 64 [16.5%], legs pain 93 [23.9%], feet pain 52 [13.4%], head heaviness 44 [11.3%] and whole body fatigue 78 [20.1%]. These complaints were significantly associated with long-term duration-response in building construction industry. Furthermore, cigarette smokers had little higher percentage of musculoskeletal complaints compared to non-smoker companions. Building construction occupation is a prolific source of musculoskeletal ailments and complaints were significantly increased with long-term working duration in building construction industry

Comparison of the impact of powerpoint and chalkboard in undergraduate medical teaching: an evidence based study

To compare the impact of the PowerPoint multimedia presentation and chalkboard in teaching by assessing the knowledge based on the marks obtained. Cross-sectional study. Department of Physiology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from December 2007 - June 2009. Three-hundred male medical students were divided into three groups and a selected content-based lecture in physiology was delivered. For one group lecture was delivered using PowerPoint presentation, for second group using chalkboard and for third group the lecture was delivered by using both PowerPoint as well as chalkboard. Single-best Multiple Choice Questions [MCQs] paper was used for assessing the knowledge gained. The same exercise was repeated in another medical science school for the confirmation of validity and reliability of the results. Students who attended the class on both PowerPoint and chalkboard obtained significantly higher score in single best MCQ examination compared to those students who attended the same content based lecture on the PowerPoint or chalkboard alone [p = 0.05]. The integrated [PowerPoint and chalkboard] method of teaching was found more suitable tool of teaching and learning than PowerPoint or chalkboard alone

Giving feedback in medical teaching: a case of lung function laboratory/spirometry

Feedback in medical teaching is an important part of medical education, it encourages and enhances the learners' knowledge, skills and professional performance at various stages of their schooling. A constructive feedback enhances the awareness of strength and areas for improvement. An adequate, meaningful and fruitful feedback needs motivation, emphasis, objectivity, expertise, and active participation in the session. Before giving feedback, the instructor should be well prepared and must have practice on the task. The instructor should utilize all means such as good oral presentation, eye contact, visual cues, utilize body language to actively involve the learners in a session, all these activities enhance the knowledge, skill and attitude of the learners. The aim of this commentary is to highlight the basic issues in giving an appropriate feedback in medical teaching with special emphasis on a lung function laboratory / Spirometry

Hypospermatogenesis and spermatozoa maturation arrest in rats induced by mobile phone radiation

To determine the morphological changes induced by mobile phone radiation in the testis of Wistar albino rats. Cohort study. Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia, from April 2007 to June 2008. Forty male Wistar albino rats were divided in three groups. First group of eight served as the control. The second group [group B, n=16] was exposed to mobile phone radiation for 30 minutes/ day and the third group [group C, n=16] was exposed to mobile phone radiation for 60 minutes/day for a total period of 3 months. Morphological changes in the testes induced by mobile phone radiation for 60 minutes/day caused 18.75% hypospermatogenesis and 18.75% maturation arrest in the testis of albino rats compared to matched controls. However, no abnormal findings were observed in albino rats that were exposed to mobile phone radiation for 30 minutes/day for a total period of 3 months. Long-term exposure to mobile phone radiation can cause hypospermatogenesis and maturation arrest in the spermatozoa in the testis of Wistar albino rats

Transmission of hepatitis-B virus through salivary blood group antigens in saliva

To determine an association between transmission of hepatitis B virus and secretor and non-secretor status of salivary blood group antigens. Cross-sectional, analytical study. The Department of Physiology and Division of Hepatology, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia, from 2007 to 2009. Eighty eight known patients, who were positive for Hepatitis B Surface Antigen [HBsAg] were recruited. Saliva was collected for investigating the secretor and non-secretor status by using blood typing kit number Kemtec Educational Science USA. Hepatitis B Surface antigen test was performed on Enzyme Linked Immunosorbent Assay technique. Polymerase chain reaction [PCR] on saliva was also carried out in High Performance Thermal Cycler-Palm-Cycler[TM] [Corbett Life Science, Sydney, Australia] and enzymatic amplification of extracted viral DNA was performed using primers covering the promoter of the core region of HBV. Out of the 88 subjects, 61 belong to blood group O, 20 to A and 7 subjects to blood group B. Fifty subjects were secretors [salivary blood group antigens positive] and 38 subjects were non-secretors [salivary blood group antigens negative]. Among core gene positive 25 [69.4%] were secretors and 11 [30.6%] were non-secretors. However, in core gene negative 25 [48.1%] were secretors and 27 [51.9%] were non-secretors. The result shows an association [p=0.047] between secretor and non-secretors status of the salivary blood group antigens with core gene positive and core gene negative

Significance of spirometry in diabetic patients

Spirometry is a widely used pulmonary function test [PFT], ideally suited to describing the effects of obstruction or restriction on lung function. It is a powerful diagnostic tool that plays a significant role in the early diagnosis of lung damage and its associated structures. It is also used to monitor the therapeutic efficacy of various treatment regimes and the course of the disease. The spirometric parameters have gained more popularity when it has been reported that impaired Forced Vital Capacity [FVC] and Forced Expiratory Volume in 1 s [FEV1] are emerging novel risk factors for type 2 diabetes mellitus. These spirometric parameter derangements have been evident on spirometry long before the clinical diagnosis of diabetes mellitus or insulin resistance. In spite of this, spirometry is not used routinely as part of a management system in diabetic patients. Its role is neither fully explored, nor fully utilized to achieve quality of life when managing diabetes mellitus. The aim of the present review is to highlight the evidence based significance of spirometry in the light of peer reviewed published literature. It may serve as a brief reference for diabetes management teams to enable spirometry to be included in the algorithm of the routine assessment of diabetic patients

Entrapment of medial plantar nerve [tarsal tunnel syndrome] in type 2 diabetes mellitus: An electrophysiological study

With increase in type 2 diabetes mellitus patients the complications of diabetes are being seen more frequently. Patients with diabetic neuropathy often present with distressing symptoms such as pain and burning sensation in the feet. Tarsal tunnel syndrome with electrophysiological changes may be a causative or contributing factor. The present study was designed to assess the presence and features of tarsal tunnel syndrome in diabetes mellitus patients. In this study a group of 10 normal volunteers were selected who had no neurological complaints or foot trauma. Another group of 33 patients having longstanding diabetes mellitus with complaints of pain, burning sensation and paraesthesia in the feet were selected for electrophysiological tests and median plantar nerve was studied. In the present study we observed that 15 [45%] of diabetic cases showed abnormal findings e.g., prolonged distal motor latency, decreased amplitude of M-response, low or absent sensory response suggesting tarsal tunnel syndrome. This study shows that the tarsal tunnel syndrome may be present in a significant number of diabetic patients with subjective neuropathic symptoms in the feet. The tarsal tunnel syndrome should be kept in mind during the diagnostic workup and management of diabetes mellitus

Diabetes mellitus: Health and wealth threat

Diabetes mellitus is a major and rapidly growing public health care problem. It is increasing in incidence, and brings with it long term complications. Presently, more than 200 million people have diabetes mellitus; by 2030, it is estimated that approximately 366 million will develop diabetes mellitus [1], and more than one third of diabetes victims are unaware that they have this disease. Over the last few decades, science and technology have dramatically revolutionized living standards, providing a luxurious life with remote control activities. Significant changes have been observed in the lifestyle of both the rural and urban population. Through this modernization and change, people are eating more, and engage in less physical activity; this contributes substantially to the development of diabetes mellitus, and indeed, is fuelling an epidemic. The ten countries estimated to have the highest number of people with diabetes by 2030 are India, China, USA, Indonesia, Pakistan, Brazil, Bangladesh, Japan, Philippines and Egypt [2]. In spite of marvelous advancements in medicine, diabetes science and technology, diabetes mellitus remains an incurable, life-long disease. It involves multiple systems, with wide ranging and devastating complications, which may lead to severe disability, and is a prime cause of excess morbidity and mortality. Among the major complications of diabetes mellitus are retinopathy with potential loss of vision, nephropathy leading to renal failure, peripheral neuropathy with risk of foot ulcers, amputations, and charcot joints, autonomic neuropathy causing gastrointestinal, genitourinary, cardiovascular symptoms and sexual dysfunction. Patients with diabetes have an increased incidence of atherosclerotic cardiovascular, peripheral arterial and cerebrovascular disease. Not only does diabetes mellitus affect the health of a large population all over the world, but it gravely affects the world's economy. Worldwide estimates suggest that the annual direct medical cost of diabetes is at least US$ 129 billion, and may be as high as US$ 241 billion, or 2.5-15.0% of global annual health care budgets [3]. Moreover, almost three million people each year, and about six people per minute, die worldwide due to the complications of diabetes mellitus [1]. Undeniably, diabetes mellitus is a leading health and wealth risk all over the world. Therefore, the sincere plea to the international health organizations and officials is that they should encourage further research in beta cell replacement strategies, and human embryonic stem cells [4]. In addition to enhancing research and the usual methods of treatment, intervention in hospital programs by adopting physiological measures and diabetes education support programs may also help to minimize the burden of this devastating disease. Moreover, electronic and print media sources should be fully utilized, in order to increase the awareness of the risk factors of diabetes mellitus, to develop understanding and control, and to promote better management and health care policies in order to improve the quality of, and access to diabetes care

Electroencephalogram findings in Saudi children with delayed language development

To determine the possible relation between delayed language development [DLD], epilepsy and epileptiform Electroencephalogram [EEG] discharges in Saudi children. This study was conducted in King Abdulaziz University Hospital, King Saud University, Riyadh, Saudi Arabia. In this study 116 pediatric patients with delayed language development and similar number of age and sex matched controls were studied. The age range for both groups was 2-8 years. Children with intelligence quotient less than 70, hearing impairment and radiological evidence of structural cerebral disease were excluded from the study. Sleep and awake EEG was recorded in each case. The EEG was reviewed by a clinical neurophysiologist and a pediatric neurologist. Within the DLD group of children, 12.07% had epilepsy. This is significantly different [p<0.001] from the control group in which none of the children had epilepsy. In DLD group 26 patients [22.41%] had epileptiform discharges in their Electroencephalogram. However, in control group only one child [0.86%] had epileptiform discharges. The delayed language development patients had a significantly higher percentage of abnormal EEGs, p<0.001 compared to the control group. Furthermore, out of the 102 DLD patients, who had no seizure, 12 [11.76%], had epileptiform discharges in their EEG. It is concluded that the children with delayed language development are associated with higher prevalence of epileptiform EEG discharges and epilepsy compared to their control

Right path of publishing a scientific paper to a right journal: academic paper based case study

Publishing of scientific manuscript in a peer reviewed bio-medical journal is an important ingredient of research along with a career enhancing advantages and significant amount of personal satisfaction. Scientific publications are golden eggs of an academic life and disseminate knowledge. These encourage discussion within the professional community and develop the scholarly base. The road to publication often seems complicated for newer authors. Therefore, the current academic based case study describes the right path of publishing a scientific manuscript in a right journal. This paper describes the experience and discusses the schooling that was learnt from the process of rejection and finally getting a paper into publication. A case study approach was adopted to facilitate the readers to understand the different influences on getting their paper in print. The present case of an academic study demonstrates that getting into print of a paper depends on a wide range of factors including the built-in importance of the research work, quality of the written text and selection of the appropriate academic journal