Climate of Online e-Learning During COVID-19 Pandemic in a Saudi Medical School: Students' Perspective.

INTRODUCTION: The circumstances of the COVID-19 lockdown offered an opportunity to develop remote educational strategies in medical education. OBJECTIVES: To assess medical students' experiences with online e-learning (OeL) satisfaction, intellectual environment, and communication during the COVID-19 pandemic. METHODS: A cross-sectional study was conducted at the College of Medicine, University of Bisha, Saudi Arabia. A self-administered questionnaire (21 items) was used to evaluate OeL in three domains of satisfaction (nine items), intellectual environment (seven items), and communication (five items). Students from years one to six were invited to fill out the questionnaire form with five-point Likert scale responses. Descriptive statistics, one-way analysis of variance (ANOVA), and independent t-test were used to evaluate the association between variables. RESULTS: Out of 237 participants, 96.6% (158 male and 71 female) responded to the questionnaire. Most students (86.5%) preferred the blackboard for their e-learning. The mean total scores were 30.18 ± 6.9 out of 45 for satisfaction, 19.67 ± 5.4 out of 25 for communication 25.43 ± 5.1 out of 35 for the intellectual environment. Over 50% of the students rated moderate scores on satisfaction and intellectual environment domains. About 85% of the students rated moderate scores in the communication domain. Male students rated higher significant scores than female students for satisfaction (31.3 ± 6.3 vs 27.6 ± 7; P < .001) and intellectual environment (26.3 ± 4.32 vs 3.5 ± 6.1; P < .001). There were no significant differences in students' responses to the tested domains related to GPA level. Significantly higher levels of scores for satisfaction (33.3 ± 5.6 vs 28.8 ± 6.9; P < .001) and communication (21.2 ± 4.5 vs 18.9 ± 5.7; P = .019) were obtained by clerkship students than pre-clerkship. CONCLUSIONS: Medical students' experiences with e-learning are encouraging, which might be more effective with continuous training programs for students and tutors. Although OeL is an acceptable methodology, further studies are needed to analyze its impact on the target learning outcomes and students' academic achievement.

Reticulocyte Hemoglobin as a Screening Test for Iron Deficiency Anemia: A New Cut-Off.

INTRODUCTION: Latent iron deficiency (LID), in which iron stores in the body are depleted without incidental anemia, poses a key diagnostic challenge. Reticulocyte hemoglobin content (Ret-Hb) is directly correlated with the functionally available iron for heme synthesis in erythroblasts. Consequently, Ret-Hb has been proposed as an efficient iron status marker. AIM: To assess the importance of Ret-Hb in detecting latent iron deficiency as well as its use in screening for iron deficiency anemia. MATERIALS AND METHODS: A study involving 108 individuals was conducted at Najran University Hospital, 64 of whom had iron deficiency anemia (IDA) and 44 of whom had normal hemoglobin levels. All patients were subjected to complete blood count (CBC), reticulocyte percentage, Ret-Hb, serum iron, total iron binding capacity (TIBC), and serum ferritin measurements. RESULTS: A significant decrease in Ret-Hb level was observed in IDA patients compared to non-anemic individuals, with a cut-off value of 21.2 pg (a value below which indicates IDA). CONCLUSION: The measurement of Ret-Hb, in addition to CBC parameters and indices, provides an accessible predictive marker for both iron deficiency (ID) and IDA. Lowering the Ret-Hb cut-off could better allow for its use as a screening parameter for IDA.

Efficacy and Safety of Mepolizumab in the Management of Severe Eosinophilic Asthma: A Systematic Review.

Severe eosinophilic asthma (SEA) is characterized by persistent airway inflammation and frequent exacerbations despite standard treatments. Mepolizumab, a monoclonal antibody that reduces eosinophil levels by targeting interleukin-5, has emerged as an add-on therapy for patients with SEA. This systematic review evaluated mepolizumab's efficacy and safety for treating SEA. A comprehensive literature search was conducted across major databases. Thirty-two studies with over 6,000 patients were included, comprising randomized controlled trials, open-label extensions, and real-world observational analyses. Study quality and risk of bias were assessed using standard tools. Meta-analysis was deemed inappropriate due to heterogeneity. Instead, a narrative synthesis was performed. Mepolizumab significantly reduced exacerbation rates by around 50% and improved symptoms and lung function compared to placebo in pivotal trials. Long-term open-label studies showed sustained reductions in exacerbations and stable lung function for up to 4.5 years. Real-world data demonstrated consistent 50%-90% exacerbation decreases across diverse patient populations over 6-24 months. Mepolizumab exhibited an acceptable safety profile, with mild injection site reactions and headaches as most common adverse events. While specific subgroups may show enhanced responses, mepolizumab displayed broad efficacy regardless of patient demographics or phenotypes. The extensive evidence provides robust support for mepolizumab as an efficacious and safe add-on treatment option for patients with severe, refractory eosinophilic asthma. Further high-quality comparative effectiveness research is warranted to optimize patient selection and positioning among emerging biologics.

Fluence-to-effective dose conversion coefficients from a Saudi population based phantom for monoenergetic photon beams from 10 keV to 20 MeV.

Fluence-to-dose conversion coefficients are important quantities for radiation protection, derived from Monte Carlo simulations of the radiation particles through a stylised phantom or voxel based phantoms. The voxel phantoms have been developed for many ethnic groups for their accurate reflection of the anatomy. In this study, we used the Monte Carlo code MCNPX to calculate the photon fluence-to-effective dose conversion coefficients with a voxel phantom based on the Saudi Arabian male population. Six irradiation geometries, anterior-posterior (AP), posterior-anterior (PA), left lateral (LLAT), right lateral (RLAT), rotational (ROT) and isotropic (ISO) were simulated for monoenergetic photon beams from 10 keV to 20 MeV. We compared the coefficients with the reference values in ICRP Publication 116. The coefficients in the AP and PA geometries match the reference values to 9% and 12% on average as measured by root mean square while those in the LLAT, RLAT ROT and ISO geometries differ, mostly below, from the reference by 23, 22, 15 and 16%, respectively. The torso of the Saudi phantom is wider than the ICRP reference male phantom and likely to cause more attenuation to the lateral beam. The ICRP reference coefficients serve well for the Saudi male population as conservative estimations for the purpose of radiation protection.

Clinico-laboratory characteristics of diabetic keto acidosis in adults in a tertiary hospital in Saudi Arabia.

OBJECTIVE: The present study is undertaken to evaluate the magnitude of DKA in Saudi population with specific emphasis on clinical laboratory characteristics over 20 years. MATERIAL AND METHODS: A prospective analysis of hospital records of 240 episodes of DKA requiring inpatient admission from December 1985 to December 2005 in adult patients in a tertiary hospital was performed. Besides the demographic data of the patients, the clinico-laboratory parameters relevant to the diabetes and DKA status were thoroughly reviewed. RESULTS: 150 males and 90 females were admitted with DKA with a mean age of 21.77 +/- 7.2 years. 16.6% (n=40) were diagnosed to have DM for the first time and others had a mean duration of DM of 5.02 +/- 4.88 years with an average daily insulin requirement being 45.09 +/- 23.9 units. 80.4% of the DKA episodes occurred in intermediate, secondary school and University level students. The commonest precipitating factors were missed insulin doses (51.2%) and respiratory tract infections (22.5%). The mean duration of stay in the hospital was 6.56 +/- 3.4 days and there were no deaths reported because of DKA. The mean blood sugar on presentation was 23.49 +/- 8.3 mmol/L whereas the mean pH and bicarbonate levels on presentation were 7.21 +/- 0.1 and 14.7 +/- 4.3 meq/L respectively. Blood pH was found to be significantly lower in female patients. Among patients below 20 years of age, females have significantly lower bicarbonate levels (11.7 +/- 6.2). Among patients above 20 years of age females had significantly longer duration of diabetes (8.86 +/- 8.36 years; p < 0.04). CONCLUSIONS: By providing intensive education and increasing the awareness of DKA, a major reduction in morbidity and hospitalizations due to DKA may be expected.