Teaching medical ethics and medical professionalism in Saudi public and private medical schools.

Medical ethics and professionalism are two essential parts of building up the identity of a competent physician. This study was conducted to determine the nature, content, and methods of medical ethics and professionalism education in Saudi public and private medical schools. It also sought to identify the challenges and obstacles in teaching and assessing medical ethics and professionalism and suggest appropriate changes. A cross-sectional study was carried out in Saudi private and public medical schools. To achieve the study's aim, an assessment tool in the form of a novel self-administered questionnaire was developed, piloted, and then used. A representative from each of the 28 Saudi medical schools participated in the study. Twenty-four (82.1%) responding medical schools have no medical ethics department. Most of the medical schools (64.2%) have 25% or less of their faculty staff who teach ethics holding a qualification in medical ethics. Most schools have a specific course for medical ethics and professionalism (85.7% and 57.1%, respectively). Multiple-choice questioning is the most popular assessment method in medical ethics and professionalism courses (89.3% and 60.7%, respectively). The need for more qualified staff and clear guidelines/resources is a significant drawback to the teaching of medical ethics. Therefore, the study recommends developing national guidelines dedicated to the undergraduate teaching curriculum from which courses would be designed to enhance medical ethics and medical professionalism.

Performance of an Arabic translation of the patient determined disease steps (PDDS) scale in Saudi patients with multiple sclerosis.

The Expanded Disability Status Scale (EDSS) is commonly used to measure and quantify disabilities in patients with multiple sclerosis (MS). The patient-determined disease steps (PDDS) scale is a patient-reported measure of disability that is useful in MS. However, the Arabic version of the PDDS has only been tested in Jordanian patients. Although both populations share similar Arabic languages, it is plausible that differences in dialects and educational systems could alter the generalizability of the tool. In this prospective study, patients with MS were asked to complete a printed translated version of the (PDDS), and the results were compared to their EDSS scores, functional system scores, and walking speed measures. Patients with relapsing or progressive MS were included in the study. Spearman rho rank-order correlation coefficients (P) were used to measure the correlation between the PDDS and other variables. We considered previously reported P values > .1, .3, and .5 as small, moderate, and strong correlations, respectively. A total of 79 patients completed the study. The PDDS showed a strong correlation with the EDSS (P = .69, 95% confidence interval 0.55-0.79, P < .001). PDDS is associated with cerebellar, pyramidal, and bladder dysfunctions. It was also moderately correlated with the timed-25-foot walk test and timed-up-and-go test. The Arabic version of the PDDS performed similarly to English and other languages when tested on a cohort of patients with MS.

The Prevalence of Depression and Anxiety in Heart Failure Patients in Saudi Arabia: An Original Study.

Background Depression is a severe comorbidity that is often detected in patients with chronic diseases. Poor prognosis may eventuate high mortality risk. Up to 30% of heart failure patients have been documented with depression and the majority upholds depression-related symptoms that may have serious clinical implications, such as hospital readmissions and fatalities. To mitigate depression-induced harms among heart failure patients, studies are being conducted to determine the prevalence, risk factors, and interventions. Objectives The current investigation is envisioned to examine the prevalence of depression and anxiety among the Saudi heart failure population. Also, it will help to explore the risk factors that will subsequently facilitate the analysis of preventive measures. Methodology The cross-sectional epidemiologic research was conducted at King Khalid University, Hospital with the recruitment of 205 participants. Each participant underwent a 30-question screening for depression, anxiety, and related risk factors. The "Hospital, Anxiety, and Depression Scale" (HADS score) was used to score subjects for the assessment of both comorbidities. The data points were subsequently analyzed by descriptive statistics and regression analysis. Results Among 205 participants, 137 (66.82%) were male and 68 (33.17%) were female with a mean age of 59.71 years. Our sample reflects a prevalence of 52.7% depression and 56.9% anxiety in Saudi heart failure patients. High depression scores were positively related to age, female gender, hospital readmissions, and pre-existing comorbidities in heart failure patients. Conclusion The study manifested high depression scores among the Saudi heart failure cohort compared to the previous survey. In addition, a substantial interrelationship of depression and categorical variables has been identified that accentuates predominating risks that can potentially promote depression and anxiety in heart failure patients.

Current Treatments of Post-traumatic Stress Disorder and Amygdala Ablation as a Potential Cutting-Edge Therapy in Its Refractory Cases.

Post-traumatic stress disorder (PTSD)is a very common psychiatric disorder occurring in an individual of any age, gender, or race who underwent trauma, with women being twice more at risk than men. It is generally seen more in American Indians, United States Latinos, and African American ethnic groups. A patient is diagnosed with PTSD if the symptoms of intrusion, avoidance, changes in cognition and emotions, arousal, and mood reactivity changes persist for more than a month and cause the individual severe difficulty in their everyday cognitive and psychological functioning. The psychological treatment includes numerous therapies including trauma-focused therapies such as cognitive behavioral therapy, cognitive processing therapy, prolonged exposure therapy, eye movement desensitization and reprocessing, and non-trauma-focused therapies such as relaxation techniques, interpersonal therapy, and mindfulness. Various pharmacological measures have also been tried with mixed results such as selective serotonin reuptake inhibitors, benzodiazepines, adrenergic drugs, atypical antipsychotics, and mood stabilizers like lithium and valproate. As numerous studies have proven, PTSD is linked with right-side stimulation of the amygdala. The purpose of this article is to highlight the use of extremely selective laser ablation of the amygdala-hippocampal unit as a successful surgical intervention for medically unresponsive PTSD and as a revolutionary solution and prospective cutting-edge therapy in the near future.

Epidemiological Trends of Human Monkeypox Cases in Northern, Southern, Western, and Eastern Regions in Europe: A Cross-Sectional Study.

Background: The growing amount of monkeypox cases in non-endemic regions raises concerns in societies as a potential pandemic. This study highlights the prevalence and epidemiological trends of a human monkeypox outbreak in various regions in Europe. Methods: This cross-sectional study was conducted in the Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia. The data about the monkeypox outbreak in European countries were recorded by the World Health Organization (WHO), and Centers for Disease Control and Prevention (CDC) reports. The period prevalence-based data were recorded from Jan 1, 2022, to July 7, 2022, and analyzed, and epidemiological trends were established in different European regions and countries. Results: In Europe, the human monkeypox rapidly spread in all the four subregions and involved 30 European countries, infecting 6077 people. The rising number of monkeypox cases is identified in Western Europe, 2599 (42.76%); Southern Europe, 1932 (31.79%); Northern Europe, 1487 (24.46%); and Eastern Europe, 59 (0.97%). In Western Europe, significant cases are found in Germany (1304), France (604), the Netherlands (352), Belgium (168), and Switzerland (131). In Northern Europe, it is found in the United Kingdom (1351), Ireland (44), Sweden (28), and Denmark (26); in Southern Europe, it is found in Spain (1256), Portugal (415), and Italy (233). However, a smaller number of cases are found in Eastern European states, Hungary (22), Poland (13), and Romania (12). The results further revealed that the number of monkeypox cases per million people in Northern Europe was 14.40%; Southern Europe, 13.49%; Western Europe, 13.26%; and Eastern Europe, 0.70%. The highest monkeypox cases per million population are found in Portugal, 40.70; Gibraltar, 29.68; Spain, 26.86; the United Kingdom, 19.90; Malta, 18.12; the Netherlands, 20.54; Germany, 15.56; Switzerland, 15.14; Belgium, 14.50; France, 9.27; and Ireland, 8.90. Conclusions: In a short period, the monkeypox cases swiftly spread in 30 non-endemic European countries and involved all four European regions. The healthcare authorities must take timely decisions to control the outbreak of human monkeypox disease, as the world cannot afford the global burden of human monkeypox outbreak as another potential pandemic.

Seasonal variations impact on SARS-CoV-2 incidence and mortality in southern and northern hemispheres: Two years pandemic period based study.

Objectives: The Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) infection is a highly challenging problem in the world. The impact of weather conditions on the spread of SARS-CoV-2 has been hypothesized, but the level of understanding remains lacking. This study investigates the impact of seasonal variations on SARS-CoV-2 incidence and mortality in the Southern and Northern hemispheres. Methods: We enlisted all the countries from both hemispheres and then randomly selected 20 countries, 10 countries from each hemisphere. After that, we recorded the SARS-CoV-2 daily cases and deaths in these selected countries from the Worldometer for the period of two years from December 31, 2019, to December 31, 2021. Results: During the study period, in 10 selected countries of the Northern hemisphere, the number of SARS-CoV-2 cases was 18381.6 ± 419.7 and deaths 300.4 ± 6.4. However, the number of cases in the southern hemisphere is 6282.9 ± 205.8, and mortality was 210.0 ± 7.7. In the Northern hemisphere, the number of SARS-CoV-2 cases (p = 0.001) and deaths (p = 0.001) significantly increased compared to the southern hemisphere. The maximum number of cases and deaths occurred during the winter (18806.4 ± 785.3) and autumn (17034.1 ± 538.4) periods in both the hemisphere compared to spring and summer. Similarly, the number of deaths increased in winter (391.0 ± 13.4, p = 0.001) and autumn (308.6 ± 11.6) compared to spring and summer in both hemispheres. Conclusions: The highest occurrence of SARS-CoV-2 cases and deaths was found during the winter and autumn seasons, while the lowest was found in the spring and summer during the study period of two years. The health officials inform the public about the seasonal occurrence of the SARS-CoV-2 outbreak and take priority preventive measures to minimize the disease burden.