ABSTRACT
Background High blood pressure is a major cardiovascular risk factor. It is a leading cause of increasing morbidity and mortality worldwide. One-third of the adult population worldwide suffers from hypertension. Salt intake, obesity, decreased physical activity, and smoking are well known to increase blood pressure. Fluid retention is the main contributing factor to primary hypertension and adversely affects the cardiovascular system. The emerging evidence suggests a relationship between blood pressure and hydration status. Our study aims to assess the correlation between hydration status and blood pressure. We aim to assess the hydration status in subjects with normal and high blood pressure and to investigate the association of hydration status with hemodynamic measurement. Methodology This cross-sectional and observational study included adult (>18 years) male and female subjects who agreed to participate. In total, 235 subjects were recruited by convenience sampling from (1) patients and caregivers attending geriatric and internal medicine clinics, and (2) visitors coming to King Fahad University Hospital at Al-Khobar. There were five patients on oral diuretics who were excluded from the study. Data were collected from September 2021 to March 2022. Hydration status was measured by a bioelectrical impedance analyzer (Bioscan 920, Maltron International Ltd. Rayleigh, UK). Hemodynamic measurements included heart rate per minute, systolic blood pressure, diastolic blood pressure, pulse pressure (the difference between systolic and diastolic blood pressure), and mean arterial pressure calculated as blood diastolic pressure plus one-third of pulse pressure. Statistical analyses were performed using SPSS statistics for windows, version 28.0 (IBM Corp., Armonk, NY, USA). Descriptive data were reported using means with standard deviations for numerical data and relative frequencies (percentage) for categorical data. P-values of less than 0.05 were considered statistically significant. Comparison between groups was done using a one-way analysis of variance test. Results Extracellular water percentage was higher in hypertensive (45.0 ± 2) than prehypertensive (43.5 ± 3) or normotensive (43.0 ± 2) (p = 0.001) subjects. In contrast, intracellular water percentage and total body water percentage were significantly negatively related to hypertension status. Conclusions Our results have shown a strong association between hypertension status and hydration parameters. In our study, hypertensive subjects tended to have lower total body water percentage and intracellular water percentage (bioimpedance value) than normotensive subjects. This might promote more research regarding the relationship between hypohydration and cardiovascular disease pathophysiology. This outcome should raise awareness about proper hydration as hypohydration can be a causative factor for hypertension.
ABSTRACT
INTRODUCTION: The primary objective of this study was to explore student and faculty perception of the objective structured clinical examination (OSCE) to assess the clinical competence of 5th year medical students. METHODS: Two validated tools were used to survey students' and faculty perception of the OSCE as an assessment tool. The questionnaires were self-administered and handed to the students immediately after the OSCE was conducted. Subjects were 29 female students who had completed their 3-week Internal Medicine rotation and 15 faculty members who had participated in evaluating the students. The response rate was 100%. The OSCE comprised of 21 active stations involving skills like history taking standardized patients were used, physical examination, and data interpretation for which real patients were used, physical examination, or management. Standardized or real patients were used in 16 stations. RESULTS: Majority of students, 63.2% indicated that the OSCE assessed their skills fairly. This was also true for 80% thought the OSCE was a fair method of assessing students' skills as well as a better assessment tool than the traditional long/short case exams. CONCLUSION: The OSCE was positively perceived by 5th year medical students and faculty members as a tool that can fairly assess students' clinical skills.
