Depression, anxiety and stress among medical and non-medical students in Saudi Arabia: An epidemiological comparative cross-sectional study.

OBJECTIVES: To quantify the extent and variation of depression, anxiety and stress among medical and non-medical Saudi Arabian students. METHODS: In this cross-sectional study, students from Umm Al-Qura University, Makkah, Saudi Arabia, were recruited. The Faculty of Education was randomly selected to represent the non-medical colleges. The depression, anxiety and stress scale-21 items (DASS-21) was used to estimate the study outcomes. RESULTS: Of the 465 undergraduates recruited in this study, 49.68% (n=231) were medical students and 50.32% (n=234) were non-medical students. Approximately 54%, 53%, and 38% of the participants were found to be suffering from depression, anxiety, and stress, respectively. The analyses showed that the two groups did not differ significantly with respect to stress and depression (p=0.934 and 0.423, respectively). However, the non-medical students exhibited a significantly higher anxiety score compared to the medical students (p=0.002). Family conflicts was a common risk factor for the studied psychological disturbances. Female gender and travel time from home to university were significant predictors of depression and anxiety, whereas a positive history of a psychological condition increased the likelihood of depression and stress. CONCLUSION: There was a high prevalence of anxiety, stress, and depression among the students, with a significantly higher anxiety levels among the non-medical students.

Patterns of emergency department visits during Hajj period: Towards healthcare optimization in view of Saudi Arabia's vision 2030.

OBJECTIVE: This study aimed to examine the pattern of emergency department (ED) visits by Hajj patients and determine the urgency of emergency visits at an advanced healthcare center. METHODS: A retrospective review of medical records of Hajj patients visiting the ED at King Abdullah Medical City Makkah from September 1 to October 5, 2015 was conducted. RESULTS: We considered 233 visits by 199 Hajj patients. Most diseases were cardiovascular related. Approximately half of the ED visits led to hospital admission, which were largely during the evening and nighttime. Potentially avoidable visits were significantly encountered during the daytime. Average bed occupation time in the ED was similar for both cases: those admitted to inpatient care and discharged from ED. Results from the Canadian Triage and Acuity Scale revealed that most patients were triaged with a score of III (48.4%) followed by a clinically better score of IV (32%); however, scores did not change significantly throughout the Hajj day. CONCLUSIONS: During Hajj, a significant proportion of patients who visited the ED at the ultimate healthcare facility were discharged within 24 hours, with a higher rate in the morning-afternoon period. Both admitted and discharged cases required equal levels of care. Therefore, an extension in working days at primary care centers and optimization of advanced healthcare facilities during Hajj is currently warranted.

Dexmedetomidine and propofol sedation requirements in an autistic rat model.

BACKGROUND: Autism is a challenging neurodevelopmental disorder. Previous clinical observations have suggested altered sedation requirements for children with autism. Our study aimed to test this observation experimentally in an animal model and to explore its possible mechanisms. METHODS: Eight adult pregnant female Sprague-Dawley rats were randomly divided into two groups. Four were injected with intraperitoneal sodium valproate on gestational day 12 and four were injected with normal saline. On postnatal day 28, the newborn male rats were subjected to the open-field test to confirm autistic features. Each rat was injected intraperitoneally with a single dose of propofol (50 mg/kg) or dexmedetomidine (0.2 mg/kg). The times to loss of righting reflex (LORR) and to return of righting reflex (RORR) were recorded. On the following day, all rats were re-sedated and underwent electroencephalography (EEG). Thereafter, the rats were euthanized and their hippocampal gamma-aminobutyric acid type A (GABAA) and glutamate N-methyl-D-aspartate (NMDA) receptor gene expressions were assessed. RESULTS: Autistic rats showed significantly longer LORR times and shorter RORR times than did the controls (median LORR times: 12.0 versus 5.0 min for dexmedetomidine and 22.0 versus 8.0 min for propofol; P < 0.05). EEG showed a low-frequency, high-amplitude wave pattern 2 min after LORR in the control rats. Autistic rats showed a high-frequency, low-amplitude awake pattern. Hippocampal GABAA receptor gene expression was significantly lower and NMDA gene expression was greater in autistic rats. CONCLUSIONS: This study supports the clinical observations of increased anesthetic sedative requirements in children with autism and our biochemical analyses using GABAA and glutamate receptor gene expression highlight possible underlying mechanisms.

Prevalence and intensity of smoking among healthcare workers and their attitude and behavior towards smoking cessation in the western region of Saudi Arabia: A Cross-sectional study.

INTRODUCTION: This study aimed to estimate the magnitude of tobacco smoking among healthcare workers (HCWs) and to assess the need to establish a smoking cessation program. METHODS: This is an institute survey that targeted HCWs from the following specialties: physicians, allied healthcare professionals and administrative workers who are affiliated to a tertiary healthcare institution in the western region of the Kingdom of Saudi Arabia (KSA). An electronic self-administrated questionnaire was distributed among the study subjects during the day shift from June to September, 2015. The analysis was descriptive, and comparison of the characters of smokers and nonsmokers was done. RESULTS: The total number of participating HCWs was 697 with about 62.3% response rate. Males (62.3%), allied health professionals (45.2%), and age group 19-30 years old (44.5%) dominated the sample. The crude prevalence of the current smoking was 18.4%, while 9.8% were past smokers, and 71.9% never smokers. Administrative workers, males and Saudis demonstrated significantly higher prevalence of current smoking (p>0.001). Approximately half of the current smokers had a mild smoking intensity and the subgroups did not show any significant differences for nicotine dependence (p>0.05). The results of the attitude towards smoking cessation showed that 80.3% of the currently smoking HCWs had positive attitudes and there were no statistically significant differences based on the characteristics of the participants (p>0.05). CONCLUSIONS: The smoking prevalence among HCWs included in the study parallels nationally reported values. The results showed a need for the establishment of smoking cessation programs targeting HCWs, which eventually should make Mecca (Makkah) city truly free from smoking.

Diagnosis and Control of Hypertension as Indicators of the Level of Awareness Among Relatives of Medical Students in Saudi Arabia.

INTRODUCTION: Patients' awareness plays an important role in the early diagnosis and control of many diseases including hypertension. AIM: To estimate the level of awareness among relatives of medical students by assessing the prevalence of undiagnosed and uncontrolled hypertension. METHODS: A predefined group of medical students were recruited and properly instructed in order to conduct this cross-sectional study among their respective first-degree adult relatives whom their sociodemographic and medical history were obtained along with their blood pressure readings. According to the absence or presence of hypertension in their history, relatives with high blood pressure were considered as undiagnosed or uncontrolled hypertension, respectively; while those who had normal blood pressure were considered as normal or controlled hypertension, respectively. Comparative analysis of different parameters was carried out between these subgroups. RESULTS: We included 770 relatives of 82 (57.7 %) total students' participations. The prevalence of undiagnosed hypertension among the total study population was 14.4 % (111 cases). Among participants with previously diagnosed hypertension, 61.9 % were uncontrolled at the time of the study. Predictors for undiagnosed hypertension were age below 40 years, working at the present time in either governmental or private sectors, current smoking, absence of diabetes and cardiac diseases. None of the investigated factors showed to be a significant predictor for uncontrolled hypertension. CONCLUSIONS: There is insufficient level of awareness among family members of clinically oriented medical students, as demonstrated by the high prevalence of both undiagnosed and uncontrolled hypertension. The most frequent profile associated with the lowest awareness level is that of the young smoking employee with no history of diabetes or cardiac disease.