Prevalence of discharge against medical advice and its associated demographic predictors among pediatric patients: A cross-sectional study of Saudi Arabia.

BACKGROUND: Discharge against medical advice (DAMA) occurs when the patient or their caretaker leaves the hospital against the recommendation of their treating physician. DAMA may expose the children to a high risk of inadequate treatment, which may result in readmission, prolonged morbidity, and mortality. The study aimed to identify the predictors of DAMA in the emergency department (ED) within the pediatric age group. METHODS: This was a cross-sectional study. The study used the medical records of pediatric patients (n = 5609) that were admitted to the ED of King Abdullah Bin Abdulaziz University Hospital (KAAUH) in Riyadh, Saudi Arabia, during 2017 and 2018. Descriptive statistics, Chi-square, or Fisher's exact test were used. Unadjusted and adjusted odds ratios with their 95% CI were reported by performing logistic regression modeling. RESULTS: A significant interaction between age and gender was observed in the multivariate analysis after adjusting for the other covariates. The odds of DAMA for a 5-year-old female child were 4.43 times higher than those of a 5-year-old male child (P < 0.1). CONCLUSIONS: The public should be educated about the consequences of DAMA. Continued health education and the promotion of child survival strategies at the community level, combined with an improvement in the socioeconomic conditions of the population, may further reduce DAMA and improve the chances of survival for children. Future studies should assess the socioeconomic status of the patients and estimate the cost that is incurred by the patients.

Establishment of an Accelerated Doctor of Family Medicine Program at Unaizah College of Medicine, Qassim University, Kingdom of Saudi Arabia.

Primary health care is well known to be the cornerstone for the health of the society. Furthermore, efficient health care at the secondary and tertiary levels is entirely dependent on effective primary health care. The Kingdom of Saudi Arabia (KSA) is currently building up a rigorous primary health care system with a large number of well-equipped primary health care centers. However, there is an acute shortage of Saudi family physicians throughout the country; both in urban and rural areas. There is no evidence in the literature supporting the relatively long 7 years' traditional duration of medical programs in the KSA. Rather, several US and Canadian medical schools have established accelerated programs in Internal Medicine and Family Medicine with graduates comparable with those of the traditional curricula in terms of standardized tests, initial resident characteristics, and performance outcomes. In response to the challenges the KSA is facing in primary health care, Unaizah College of Medicine at Qassim University is proposing to establish an accelerated Doctor of Family Medicine Program that would run for total duration of 6 years. Herein, we describe a concise outline of this program.

Study on the interaction of antidiabetic drug Pioglitazone with calf thymus DNA using spectroscopic techniques.

Pioglitazone is an antidiabetic drug used to treat type 2 diabetes mellitus. Interaction of Pioglitazone with calf thymus DNA was investigated using multispectroscopic techniques and molecular docking study. Quenching and binding constant was calculated at 3 different temperatures. The binding constant of Pioglitazone with calf thymus DNA was calculated to be 6.49 × 103 M-1 at 293 K. The quenching mechanism was found to be a static process, and thermodynamic parameters revealed van der Waals interactions and hydrogen bonds to be the major force working in Pioglitazone-DNA interaction. Pioglitazone follows the nonintercalative mode of binding and was involved in complex formation with DNA through minor groove binding and electrostatic interactions. Experiments like KI quenching studies, dye displacement assays, Circular Dichroism (CD) spectroscopy, DNA melting study, and viscosity measurements studies supported the nonintercalative mode of binding. This was further corroborated by molecular docking studies.

Interaction of procarbazine with calf thymus DNA-a biophysical and molecular docking study.

Interaction of procarbazine (PCZ) with calf thymus DNA was studied using biophysical and molecular docking studies. Procarbazine was to interact with DNA with a binding constant of 6.52 × 103  M-1 as calculated using ultraviolet-visible spectroscopy. To find out the binding mode, molecular docking was performed that predicted PCZ to interact with DNA through groove binding mode with binding affinity of -6.7 kcal/mole. To confirm the groove binding nature, different experiments were performed. Dye displacement assays confirmed the non-intercalative binding mode. Procarbazine displaced Hoechst dye from the minor groove of DNA while it was unable to displace intercalating dyes. There was no increase in the viscosity of DNA solution in presence of PCZ. Also, negligible change in the secondary structure of DNA was observed in presence of PCZ as evident by circular dichroism spectra. Procarbazine caused decrease in the melting temperature of DNA possibly because of decrease in the stability of DNA caused by groove binding interaction of PCZ with DNA.

Developing a generic model for total quality management in higher education in Saudi Arabia.

The field of higher education has been progressing at a rapid pace in the Kingdom of Saudi Arabia over the past decade, with doubling the number of government and private universities and colleges. Quality and accreditation are of great importance to higher education institutes world-wide. Thus, developing a generic model for quality management in higher education is badly needed in the country.