Weight reduction among females undergoing laparoscopic ventral hernia repair: The role of Calcium and Vitamin D3.

Objective: To evaluate the role of Vitamin-D and calcium supplementation on preoperative weight reduction in obese women before laparoscopic ventral hernia repair. Methods: This double-blind clinical trial was conducted at the affiliated health centers of King Faisal University, Al-Ahsa, Saudi Arabia from January 2021 to December 2021. It included forty-five obese women aged 24-56 years, with body mass index (BMI) of 34.0-48.0kg/m2. They were randomly allocated into two groups; the Group-A (N=22) included obese women who received supplementation of 5000IU cholecalciferol (Vitamin-D3), and 1000mg calcium daily for 12 months, while the Group-B (N=23) received no treatment. Measurement of change in weight and BMI and comparison of their pre-operative weight reduction, laparoscopic operative time, and length of hospital stay was done. Results: There were no differences in patients' biographic data between the two groups. During the study, Vitamin-D level in the patients increased and there was a significant positive association with weight loss. In group-A, the mean weight loss was 11.8±3.5 kg. At the end of first year, their BMI decreased from 36.1±1.6kg/m2 at baseline to 29.7±2.6 kg/m2, whereas in-group-B, the mean weight loss was 6.8±3.1 kg and their BMI decreased from 36.9±2.69kg/m2 at baseline to 32.7±0.93kg/m2. The operation time and the length of hospital stay were shorter in group-A (107 vs.128.min) and (3 vs. 5 days) respectively as compared to Group-B. Conclusion: Vitamin-D and calcium supplementation contributes to a remarkable weight reduction of preoperative obese female patients, which in turn is associated with significantly better outcome of laparoscopic repair of ventral hernia.

COVID-19 and Its Impact on Back Pain in the Eastern Province of Saudi Arabia.

Background Low back pain (LBP) is a common musculoskeletal condition that affects individuals worldwide, causing difficulties in daily tasks and social interactions. It can be categorized based on chronicity, with acute, subacute, and chronic forms. The causes of backache vary among patients and can include inflammatory conditions, radiculopathy, pregnancy, trauma, osteoporosis, nerve root compression, cancer, plexopathy, infection, and other spinal diseases. Aim The aim is to investigate the association between COVID-19 infection and LBP between all Saudi adults and foreign adults who had positive COVID-19 tests in the eastern region of Saudi Arabia. Methods A cross-sectional study was conducted in the Eastern Province of Saudi Arabia over the period from March 2023 to August 2023. Participants were selected by using a convenience sampling method, a sample (n=500) of individuals. The structured questionnaire was used to gather information on sociodemographic variables and COVID-related features. All the statistical calculations were performed using the SPSS software (by IBM) version 29.0.0. Results 482 participants completed the questionnaire. Out of 482 participants, the majority were females with a number of 372 (77.2%) aged between 20 and 29 years (38.4%). Out of the remaining participants, 110 (22.8%) were males. Most of the participants with a number of 301 (62.4%) were from the Hasa province. This was followed by Qatif (79, 16.4%), Dammam (56, 11.6%), Jubail (25, 5.2%), and others (21, 4.4%). The study revealed that 10.1% of participants reported experiencing back pain. The duration of backaches varied among respondents, with 122 (25.3%) experiencing them from a day to a week, 28 (5.8%) enduring them for six weeks, and 65 (13.5%) reporting a duration of six to 12 weeks. The majority, comprising 267 (55.4%) respondents, were uncertain about the period of their backaches. The prevalence of COVID-19 infection among the participants was 357 (74.1%), and 477 (99.0%) had been vaccinated against COVID-19. Approximately 44.4% of the participants experienced back pain, and out of those, 28.2% reported having pain during quarantine. Among the individuals with back pain, 24.7% attributed it to COVID-19. Conclusion This study highlights the significant correlation between back pain and COVID-19, even after the resolution of other symptoms. It underscores the importance of further research into the long-term effects and mechanisms of this association. The findings emphasize the need for healthcare professionals to consider back pain as a potential aspect of the post-COVID-19 symptom profile, ensuring comprehensive care for affected individuals.

The impact of coronavirus crisis on human interpersonal relationships among AlAhsa population.

Background: Home quarantine during the coronavirus disease 2019 pandemic was a clear cause of loss of communication and a lot of conflicts between individuals, which had adverse consequences on people's relationships. Objective: This study aims to assess the effect of lockdown on interpersonal relationships in AlAhsa community. Methods: A.cross-sectional study was conducted during 2020-2021 with 306 participants in AlAhsa, the eastern region of Saudi Arabia. The data were collected using an online survey to explore the effect of lockdown on interpersonal relationships. Results: The study demonstrates that (61.8%) of the participants reported that their relationships were affected during lockdown, (61.4%) of them were affected negatively, with a higher rate among the unemployed and students (73.1%) and (64.8%), respectively. About 38.6% of the individuals were positively affected. Conclusion: Most of the participants identified that quarantine affected their interpersonal relationships negatively, which were impacted variably by different demographical statuses.

Résumé Contexte: La quarantaine à domicile pendant la pandémie de la maladie à coronavirus 2019 a été une cause évidente de perte de communication et de nombreux conflits entre individus, ce qui a eu des conséquences néfastes sur les relations interpersonnelles des gens. Objectif: Cette étude vise à évaluer l'effet du confinement sur les relations interpersonnelles dans la communauté d'AlAhsa. Méthodes: Une étude transversale a été menée de 2020 à 2021 avec 306 participants à AlAhsa, dans la région est de l'Arabie saoudite. Les données ont été collectées à l'aide d'une enquête en ligne afin d'explorer l'effet du confinement sur les relations interpersonnelles. Résultats: L'étude démontre que (61,8 %) des participants ont déclaré que leurs relations ont été affectées pendant le confinement, (61,4 %) d'entre eux ont été affectés négativement, avec un taux plus élevé parmi les chômeurs et les étudiants (73,1 %) et (64,8 %), respectivement. Environ 38,6 % des individus ont été affectés positivement. Conclusion: La plupart des participants ont identifié que la quarantaine a eu un impact négatif sur leurs relations interpersonnelles, impactées de manière variable par différents statuts démographiques. Mots-clés: Maladie à coronavirus 2019, relations interpersonnelles, Arabie saoudite.

Impact of COVID-19 Vaccinations on Menstrual Bleeding.

INTRODUCTION: Vaccination has a fundamental role in protecting against and modifying the severity of several infectious diseases, including COVID-19. Several immune and non-immune adverse events have been reported post-COVID-19 vaccine. The aim of this study was to assess the effect of the COVID-19 vaccine on women's menstrual bleeding. METHODS: A cross-sectional study was conducted among 399 vaccinated women in the Eastern Province of Saudi Arabia. Data were collected using a direct interview-based questionnaire including four sections. RESULTS: A total of 399 women were recruited, with a mean age of 25.54 ± 6.177 years. More than half (53.9%) of the participants reported post-vaccination menstrual bleeding abnormality in terms of a heavy or irregular cycle. Out of the total number, 40 (21.4%) women reported having heavy menstrual flow, and 67 (16.8%) had non-menstrual bleeding after receiving the COVID-19 vaccine. Fully vaccinated women were at a greater risk of post-vaccination menstrual bleeding abnormality (p = 0.058). However, there was no correlation between booster shot type and menstrual bleeding abnormality (p > 0.05). In addition, there was no significant association between non-menstrual bleeding and the type of booster shot, the type of the first dose, and prior history of COVID-19 infection (p > 0.05). CONCLUSION: Despite vaccination being the most effective way to prevent COVID-19, it does have an impact on menstrual bleeding in terms of menorrhagia and metrorrhagia. Therefore, more studies are needed to understand the mechanism and the long-term impact of COVID-19 vaccines on the hemostatic system.

The Role of Physicians' Factors in Underdiagnosis of Celiac Disease in the Eastern Province of Saudi Arabia.

Background Celiac disease is an autoimmune disorder triggered by gluten and related prolamines, which can cause a variety of symptoms and complications if left untreated. Despite being a common lifelong disorder, it often goes undiagnosed for a long time, leading to negative impacts on patients' health and quality of life. The diagnosis of celiac disease requires the presence of celiac-specific autoantibodies and distinctive histological changes in the small intestinal mucosa. Lack of disease knowledge among healthcare professionals and patients' adherence to gluten-free diets may contribute to diagnostic delays. Objectives This study aims to assess the reasons for celiac disease underdiagnosis and identify the functional deficiencies of healthcare professionals in the diagnosis and treatment of celiac disease, particularly in the Saudi population. Materials and methods A cross-sectional, questionnaire-based study was conducted among physicians in the Eastern Province of Saudi Arabia during the year 2023, between May and July. Participants were asked to complete an online self-administered questionnaire that included questions about their demographic characteristics, professional experience, and knowledge and attitudes toward celiac disease. The study recruited gastroenterologists, gastroenterology fellows, internal and family medicine specialists, residents, and general practitioners working in private or public health centers in various cities of the Eastern Province. Results The data were collected from 180 physicians who fulfilled the inclusion criteria of the study, with most participants aged under 30 years and predominantly male. Family medicine and general practitioners were the most represented specialties. While 49.4% of physicians knew that adult celiac disease was rare, only 19.4% frequently recommended celiac disease serology to their patients. In terms of risk, most physicians knew that adult celiac disease was a moderately severe and disabling disease, but only 24.4% thought that the cancer risk in patients with celiac disease was moderate. About 75.6% of physicians had an overall poor knowledge level regarding celiac disease, with gastroenterologists and internal medicine specialists demonstrating better knowledge compared to other specialties (P = 0.001). Conclusion The study found that a majority of physicians in the Eastern Province of Saudi Arabia had poor knowledge about celiac disease. This lack of knowledge could have implications for patient care, as it could lead to delays in diagnosis, inadequate treatment, and increased risk of complications.

Electrocardiogram Interpretation Competency of Medical Interns in Saudi Arabia: A Cross-Sectional Study.

Objective To determine the competence of medical interns in Saudi Arabia in interpreting common ECG abnormalities, explore limitations, and facilitate solutions to the development of ECG interpretation skills in Saudi Arabia. Methods This cross-sectional study was conducted from 11 June 2022 to 3 November 2022 using the convenience stratified sampling technique among 373 medical interns (54.4% male and 45.6% female) in 15 medical colleges within Saudi Arabia. Results Almost all (91.7%) of the participants recognized the basic ECG elements, as they correctly identified normal ECG patterns. The most well-understood ECG pathologies were ventricular fibrillation, atrial fibrillation, and acute myocardial infarction, which were accurately interpreted by 69.2%, 67.8%, and 61.9% of the participants, respectively. The least understood ECG result was a pathological Q wave, which only 20.9% recognized. Most (63.5%) participants attributed their challenges in ECG interpretation to their inadequate training in college, and 57.4% of them stated that practical case-based training could best facilitate the improvement of their skills in ECG interpretation. Conclusion Most of the participants showed unsatisfactory performance in ECG interpretation. Despite their completion of advanced cardiac life support courses, their overall performance did not improve significantly. Most of them believed that their colleges did not adequately train them to read ECGs. Thus, a majority think case-based training is a key strategy for improving their ECG interpretation skills.

Patients' Awareness of Their Rights and Responsibilities: A Cross-Sectional Study From Al-Ahsa.

Introduction Patient rights are an essential part of healthcare practice. In fact, patients are one of the most vulnerable members of society. As a result, improving the rights of patients is considered a priority in medical services. Aim The purpose of this study is to measure the level of patients' awareness of their rights. Subjects and methods This is a cross-sectional study conducted among patients living in Al-Ahsa, Saudi Arabia. A self-administered questionnaire was distributed among Al-Ahsa patients using an online survey. The questionnaire was composed of socio-demographic variables (i.e., age, gender, education, etc.), sources of patient information regarding patients, means of increasing awareness toward patients' rights, and a 15-item questionnaire to measure the awareness about patient rights and responsibilities. Results Among the 295 patients, 59.7% were males and 39% were aged between 31 and 40 years old. The overall mean awareness score was 54.6 (SD 7.44). 53.2% of the patients were categorized as having moderate awareness levels, 44.1% were good and only 2.7% were categorized as having poor levels of awareness. Factors associated with increased awareness were being older, hospital admission, hospital visitation for the last three months, and healthcare providers as the sources of the patient's right information. Conclusion There was sufficient awareness of patient rights and responsibilities in our region. Increasing age, frequent hospital visitation, and education given by healthcare providers could effectively improve awareness of patient rights and responsibilities. A multicenter study is required to shed more light on the awareness of patients regarding their rights and responsibilities.

Psychological Impact of Acne Vulgaris Among Young Females in the Eastern Province, Saudi Arabia.

Introduction Acne vulgaris is considered one of the most common dermatological issues that affect approximately 9.4% of the world's population, and the most affected group is adolescents. Acne can vary among adolescents and adults of different ethnicities and countries. Aim This study aimed to assess the psychological impact of acne vulgaris among female adults in the Eastern province of Saudi Arabia. Subjects and methods This is a cross-sectional study conducted among young females aged 15 to 25 years old. A self-administered validated questionnaire translated into Arabic was distributed among the female respondents with acne vulgaris using an online survey. The questionnaire includes basic demographic data and the Dermatology Life Quality Index (DLQI) questionnaire to assess the psychological impact of acne vulgaris. Results Four hundred seventy-six female participants aged 15-25 years took part. The majority were single (86.3%) and of Saudi nationality (92.4%). The prevalence of psychological impact affecting acne patients was 85.5% (ranging from low effect to severe effect). A significant relationship was observed between psychological impact according to marital status (p=0.034) and educational level (p=0.023). In a multivariate regression model, patients who had never been married and were more educated were the independent significant factors associated with increased rates of psychological impairment. Conclusion The quality of life of young females has been greatly affected by acne vulgaris. The severity of psychological impairment associated with acne vulgaris can be significantly predicted among educated and single females. Psychological counseling is necessary to decrease the burden caused by the dermatologic condition affecting young females in the region.

Earning Engagement via E-health (EEE Project).

All medical schools are committed to engaging the community in addressing their health issues; however, no one has yet successfully implemented or established them. The EEE project bridges the link between medical schools and the community and has been launched for the first time to engage our students in real community involvement in the use of new information technology in the Arab context.

Hydroxyurea usage awareness among patients with sickle-cell disease in Saudi Arabia.

BACKGROUND AND AIM: Hydroxyurea (HU) plays an essential role in the complex pathophysiology alteration of sickle-cell disease (SCD), which translates clinically into the enhanced quality of life and increased survival. This research examines adult patients with SCD's attitudes and awareness toward HU, as well as underutilization consequences. METHOD: A cross-sectional research was performed in Saudi Arabia, and adult patients with SCD were interviewed. The survey includes patient demographics, attitudes, and knowledge of HU and clinical data. The chi-square was applied through SPSS version 23 for assessing any association with outcome variables and demographic characteristics. RESULTS: HU is known to 72 (67.3%) of the 107 patients. The hydroxyurea treatment was initiated in 46 patients (63%). Of these, 23 (50%) discontinue HU, with the key factors being pregnancy preparation and side effects development. For those who were unaware of HU, 13 (37.1%) were admitted to the intensive care unit because of acute chest syndrome, 29 (82.8%) required a frequent blood transfusion and 12 (34.2%) with frequent hospitalizations. However, there was no significant relationship between awareness and education level (P value is .078 > .05). In addition, there was no significant relationship between the level of awareness and age and gender of participants (P value is .68 and .44, respectively). CONCLUSION: HU is a long-established and effective disease-modifying agent for SCD patients, but it is underutilized. The causality of underuse is bidirectional between patients and healthcare providers. It is essential to educate healthcare providers and patients with SCD about hydroxyurea role in modifying disease severity, resolving adverse events, and achieving full benefits.

The Potential Preventive Effect of Pregnancy and Breastfeeding on Multiple Sclerosis.

BACKGROUND: Multiple sclerosis (MS) is an inflammatory demyelinating chronic neurological disease that affects the central nervous system of young adults and their quality of life. Several studies have investigated the effects of pregnancy and breastfeeding on MS. However, the evidence regarding the influence of pregnancy and breastfeeding on MS is still accumulating. This review aimed to summarize the current evidence regarding the effects of pregnancy and breastfeeding on MS. SUMMARY: A systematic electronic literature search of the PubMed and Embase databases was conducted to determine relevant published articles. The eligible studies were summarized and evaluated in tables. Key Messages: The majority of the studies indicated that pregnancy appears to lower the rate of MS relapses, particularly in the third trimester. The evidence regarding the effect of breastfeeding on MS remains inconsistent. Despite reports of negative obstetric outcomes in some pregnant women with MS, pregnancies in women with MS should not be categorized as high-risk pregnancies.

Evaluation of hospital-learning environment for pediatric residency in eastern region of Saudi Arabia.

PURPOSE: No study had been conducted to assess the hospitals' environment for learning purposes in multicenter sites in Saudi Arabia. It aims to evaluate the environment of hospitals for learning purposes of pediatric residents. METHODS: We applied Postgraduate Hospital Educational Environment Measure (PHEEM) to measure the learning environment at six teaching hospitals in the Eastern Region of Saudi Arabia from September to December 2013. RESULTS: The number of respondents was 104 (86.7%) out of 120 residents and 37 females and 67 male residents have responded. The residents' response scored 100 out of 160 maximum score in rating of PHEEM that showed overall learning environment is favorable for training. There were some items in the social support domain suggesting improvements. There was no significant difference between male and female residents. There was a difference among the participant teaching hospitals (p<0.05). CONCLUSION: The result pointed an overall positive rating. Individual item scores suggested that their social life during residency could be uninspiring. They have the low satisfactory level and they feel racism, and sexual discrimination. Therefore, there is still a room for improvement.

Self-assessment through videotaping compared with peer and trainer feedback.

OBJECTIVE: To assess and compare three different types of feedback for presentation skills, self, peer and trainer feedback. STUDY DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: Faculty of Medicine at Atatürk University, Erzurum, Turkey, from March 2012 to December 2012. METHODOLOGY: Participants were faculty members and instructor nurses. Each participant gave a 10-minute presentation, which was rated by peers, course trainers and the presenter himself/herself using a thirteen-item questionnaire (designed as a 5-point Likert scale). Peers and trainers conducted the assessment during the presentation while the self-assessment was done later by watching a video recording of the presentation. Comparison of the points between the groups was made using the two-way ANOVA. Pearson correlation analysis was conducted to evaluate the relationship between the mean scores of self-assessment, peer and trainer assessment. RESULTS: Ten faculty members, 27 instructor nurses and 4 trainers participated in the study. A total of 775 feedback reports were collected for 37 participants. There was no significant difference between the feedback scores of the evaluators as well as the occupation groups (p > 0.05). There was a strong positive and statistically significant correlation between trainer and peer (r = 0.73, p < 0.001). CONCLUSION: Consequently, there were no differences in the evaluations of presentation skills between different stakeholders. Trainers should use the video recording method to self-evaluate their presentation skills, and they should invite their peers from time to time to improve their own personal development by using peer review methods.

Evidence based medicine: teaching, learning and practice: results of a cross-sectional study from Turkey.

OBJECTIVE: To assess the level of understanding related to the significance of evidence-based medicine among physicians. METHODS: The cross-sectional study was conducted between March and October 2012 using an online questionnaire that was sent out to physicians and academics working as faculty at training hospitals across Turkey. The questionnaire consisted of questions about the knowledge, attitude and behaviour towards evidence-based medicine. Seven of the questions pertained to the learning of evidence-based medicine, six were about teaching evidence-based medicine, and six were about its practice. SPSS 20 was used for statistical analyses. RESULTS: The questionnaire was returned duly filled by 79 physicians. Of them, 41 (51.9%) were males; and 57 (72.2%) were part of the faculty. Only 1(1.2%) participant had attended a course about evidence-based medicine during undergraduate education, while 19 (24.05)had attended one after graduation. Besides, 26 (32.9%) academics were teaching some concepts of evidence-based medicine, and 21 (26.6%) were giving some information about clinical guidelines. CONCLUSION: The study found that levels of learning and teaching of evidence-based medicine among physicians were inadequate. They should be emphasised at both pre- and post-graduate tiers.

Validation of a computer based objective structured clinical examination in the assessment of undergraduate dermatology courses.

Many teaching centers have now adopted objective structured clinical examination (OSCE) as an assessment method for undergraduate dermatology courses. A modification of the standard OSCE in dermatology is computer based or electronic OSCE (eOSCE). We attempted to validate the use of a computer-based OSCE in dermatology in a group of fifth year medical students. The scores of the students in the computer-based OSCE showed a strong positive correlation with the scores on the clinical presentation (Pearson's co-efficient - 0.923, P value <0.000, significant at the 0.01 level) and a good correlation with overall scores of the student (Pearson's co-efficient - 0.728, P value <0.000, significant at the 0.01 level), indicating that this is a reliable method for assessment in dermatology. Generally, the students' feedback regarding the methods was positive.

Perceived self-efficacy and academic performance of medical students at Ataturk University, Turkey.

OBJECTIVE: To determine the association of perceived self-efficacy with academic performance of pre-clinical medical students. STUDY DESIGN: A cross-sectional analytical study. PLACE AND DURATION OF STUDY: Medical Education Department, Ataturk University, Turkey, from March to May 2012. METHODOLOGY: Participating students were members of the first to third year medical students class considered to be preclinical years at Ataturk University. A validated and reliable questionnaire consisted of 10 questions applied to assess the general self-efficacy of the medical students in pre-clinical years and evaluate whether their self-efficacy has relation to their academic performance. Responses and studied variables were compared using ANOVA and Pearson correlation test as applicable. RESULTS: The mean scores of three consecutive examinations were compared with self-efficacy mean scores of three classes. A validated and reliable questionnaire was used for assessment of self-efficacy. There was no correlation found in between mean examination scores and self-efficacy mean scores in first year (r = -0.11, p = 0.276), second year (r = 0.20, p = 0.180), and third year (r = -0.040, p = 0.749). However, comparison of mean scores between male and female demonstrated significant difference (p = 0.001) and males dominant in self-efficacy scores. CONCLUSION: The results illustrate in pre-clinical years at medical schools the general self-efficacy does not play any role in their performance.

Management of Legg-Calve-Perthes disease with acupuncture: a case report.

Legg-Calve-Perthes disease (LCPD) is a rare temporary hip joint deformity mostly effecting young children from 4-10 years of age. It involves mainly the head of the femur, which softens and breaks down due to interruption of blood supply (avascular necrosis). We report a case of LCPD that was treated late and had a poor prognosis, but improved significantly during a prolonged course of acupuncture. A 12-year-old boy reported to an orthopaedic clinic in 2006 with limping and was diagnosed with LCPD. Surgeons applied orthosis without improvement and decided to perform surgery in 2008. However, the parents declined the surgical option and took the boy to an acupuncture clinic the same year. Needle acupuncture for 20 min and laser acupuncture locally on the hip joint area for 5 min were applied. After 30 sessions of acupuncture, the boy started to improve clinically. Imaging studies showed that new bone cells started to develop in the femoral head. After 130 sessions in 2010 the radiographic appearance showed almost 90% improvement, and after 196 sessions, in August 2012, he was fully recovered. Needle acupuncture treatment combined with laser acupuncture may be an option for the management of LCPD.

An objective structured biostatistics examination: a pilot study based on computer-assisted evaluation for undergraduates.

We designed and evaluated an objective structured biostatistics examination (OSBE) on a trial basis to determine whether it was feasible for formative or summative assessment. At Ataturk University, we have a seminar system for curriculum for every cohort of all five years undergraduate education. Each seminar consists of an integrated system for different subjects, every year three to six seminars that meet for six to eight weeks, and at the end of each seminar term we conduct an examination as a formative assessment. In 2010, 201 students took the OSBE, and in 2011, 211 students took the same examination at the end of a seminar that had biostatistics as one module. The examination was conducted in four groups and we examined two groups together. Each group had to complete 5 stations in each row therefore we had two parallel lines with different instructions to be followed, thus we simultaneously examined 10 students in these two parallel lines. The students were invited after the examination to receive feedback from the examiners and provide their reflections. There was a significant (P=0.004) difference between male and female scores in the 2010 students, but no gender difference was found in 2011. The comparison among the parallel lines and among the four groups showed that two groups, A and B, did not show a significant difference (P>0.05) in either class. Nonetheless, among the four groups, there was a significant difference in both 2010 (P=0.001) and 2011 (P=0.001). The inter-rater reliability coefficient was 0.60. Overall, the students were satisfied with the testing method; however, they felt some stress. The overall experience of the OSBE was useful in terms of learning, as well as for assessment.