Search

Mortadah Alsalman,1 Zaenb Alsalman,2 Hussain Abduljaleel Alkhalifa,3 Aman N Alfaraj,3 Ali Alkhalifah,4 Qasem Almulihi5 1Department of Medicine, College of Medicine, King Faisal University, Alahsa, Saudi Arabia; 2Department of Family and Community Medicine, College of Medicine, King Faisal University, Alahsa, Saudi Arabia; 3Department of Medicine, King Fahad Specialist Hospital, Dammam, Saudi Arabia; 4Emergency Department, Eastern Health Cluster, Dammam, Saudi Arabia; 5Emergency Department, King Fahad University Hospital, Al Khobar, Saudi ArabiaCorrespondence: Zaenb Alsalman, Departments of Family and Community Medicine, College of Medicine, King Faisal University, Po Box 3311, AlAhsa, 36346, Saudi Arabia, Tel +966545611633, Email Alsalman.zainab@hotmail.comPurpose: Sickle cell disease (SCD) comprises a complex group of hematologic disorders that are collectively the most common monogenic disorder and are associated with increased risk of intensive care unit admission (ICU). The purpose of this study is to investigate factors that predict admission of adult patients with SCD to the ICU.Patients and Methods: This was a cross-sectional study that enrolled adult patients with SCD from Saudi Arabia.Results: A total of 107 patients with SCD, with a median age 31.9± 12.1 years, were evaluated retrospectively. Regarding predictors of ICU admission, patients who indicated a history of blood transfusions were at 8.047-fold higher risk of ICU admission (OR=8.047; 95% CI=2.392– 27.07; p=0.001). Patients who started hydroxyurea were at least 3.071 times more likely to be admitted than those who did not (OR=3.071; 95% CI=1.164– 8.104; p=0.023). We also observed three or more hospitalizations per year to be associated with increased risk of ICU admission (OR=3.393; 95% CI=1.285– 8.960; p=0.014), with those making 3 to 5 visits annually having at least 10.4 times higher risk (OR=10.38; 95% CI=10.098– 98.19; p=0.041) and those with 6 to 10 ER admissions having 18 times higher risk (OR=18.00; 95% CI=2.149– 150.8; p=0.008). Finally, patients with high WBC were predicted to have at least 3.34 times higher risk of ICU admission (OR=3.337; 95% CI=1.131– 9.846; p=0.029).Conclusion: SCD is a multi-systemic disease associated with increased morbidity and mortality. Recognition of high-risk features in patients helps to eliminate subjectivity in ICU referral decision. Frequent hospitalization and emergency visits, multiple blood transfusions, and elevated white blood cell count were significantly associated with a higher rate of ICU admission despite hydroxyurea usage.Keywords: sickle cell disease, intensive care unit, hydroxyurea

Asmaa F Sharif,1 Zeinab A Kasemy,2 Nada A Alquraishi,3 Kawther N Alshaikh,3 Anwar H Alfaraj,3 Eman A Alibrahim,3 Zainb M Alfarej,3 Hawra M Alawami,3 Fatma Alzahraa A Elkhamisy4,5 1Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Tanta University, Tanta, Egypt; 2Public Health and Community Medicine Department, Faculty of Medicine, Menoufia University, Shiben ElKoom, Egypt; 3College of Medicine, Dar Al-Uloom University, Riyadh, Kingdom of Saudi Arabia; 4Basic Medical Sciences Department, Faculty of Medicine, King Salman International University, South Sinai, Egypt; 5Pathology Department, Faculty of Medicine, Helwan University, Cairo, EgyptCorrespondence: Asmaa F Sharif, Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Tanta University, Tanta, 31527, Egypt, Tel +966 581639317, Email asmaa.sherif@med.tanta.edu.egPurpose: Team-based learning (TBL) is an interactive instructional strategy designed to enhance student engagement. Few studies reported that TBL needs to be more interactive, concerns were raised regarding the insufficient instructor feedback, and students feel that TBL gets less attractive with time. One method of boosting students’ interaction and performance is adding an element of challenge or positive stress. Therefore, we hypothesized that inserting an erroneous answer in the answer key would generate an observable improvement in the selected outcomes in terms of better satisfaction, interaction, interest in learning, better academic performance, and better development of competencies compared to traditional TBL.Methods: This randomized controlled trial aimed to determine if inserting an erroneous element in the answer key of a grouped team readiness assurance test (GRAT) would update TBL and whether this intervention would enhance students’ performance and satisfaction.Results: A total of 55 medical students were recruited (88.7% response rate). Erroneous elements were inserted in the answer key of the experimental group and students enrolled in traditional TBL were considered as controls. Compared to the control group (p < 0.001), the experimental group revealed significantly higher academic performances in GRAT and team evaluation test (TET). Analysis of students’ perception of the implemented TBL revealed better perception among the experimental group (33.7 ± 6.4) than the control group (30.1 ± 7.0). Moreover, significantly higher team dynamics were reported among the experimental group than the control group (33.0 ± 6.3 and 27.8 ± 7.6 for both groups, respectively; p = 0.005). The reported advantages were in-depth understanding, easier information retrieval, and development of problem-solving skills. Students considered time and effort as their main limitations.Conclusion: Adding a few erroneous answers in the GRAT is well perceived by students, enhances their learning competencies and overcomes some TBL challenges.Keywords: learning environment, motivation, instructional design, student’s interaction, academic performance, team-based learning

Amal Alfaraj,1 Hassan S Halawany,2 Muntasar T Al-Hinai,3 Abid H Al-Badr,2 Marwa Alalshaikh,4 Khalifa S Al-Khalifa5 1Prosthodontics Residency Program, Department of Prosthodontics, School of Dentistry, Indiana University, Indianapolis, IN, USA; 2Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia; 3Dental and Maxillofacial Surgery Department, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Sultanate of Oman; 4Periodontics Fellowship Program, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 5Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaCorrespondence: Amal AlfarajProsthodontics Residency Program, Department of Prosthodontics, School of Dentistry, Indiana University, Indianapolis, IN, USAEmail asalfara@iu.eduObjective: Access to dental care is a key factor influencing oral health outcomes. Individuals with special healthcare needs are at risk of not having access to dental care services which they need to maintain their oral health. This study assessed the magnitude of this problem and identified barriers responsible for the difficulties in accessing dental care in Qatif, Saudi Arabia, as reported by caregivers of individuals with special healthcare needs.Methods: This cross-sectional study collected data using a self-administered survey questionnaire from caregivers of individuals with special healthcare needs across 11 centers (eight special needs centers and three schools) in Qatif, Eastern Province of Saudi Arabia, between February and April 2019.Results: A total of 186 caregivers participated in the study, 102 (54.8%) of whom reported difficulties in getting access to dental care. The key barriers included lack of time on the part of caregivers (60.8%), unsuitable clinic environment (53.9%), difficulties with transportation (51.9%), medical/health status of the individual with special healthcare needs (51.0%), and geographically distant dental clinics (51.0%). Caregiver demographics (age, gender, and educational level) had no significant influence on the difficulties reported by caregivers in getting access to dental care for individuals with special healthcare needs (p> 0.05).Conclusion: A large proportion of caregivers in Qatif, Saudi Arabia, experience difficulties with access to dental care services for individuals with special healthcare needs. The most common barriers are physical accessibility of dental facilities (for individuals with special healthcare needs), affordability, and lack of skills and knowledge of dental care providers.Keywords: health services accessibility, dental care for disabled, caregivers, Saudi Arabia

Nisreen H Maghraby,1 Hassan M Alshaqaq,2 Abdullah Saleh AlQattan,3 Adnan Fawzi Alfaraj,4 Omar A Alghamdi,2 Malak J Alzawad,5 David A Farcy6 1Department of Emergency Medicine, King Fahd University Hospital-College of Medicine, Imam Abdulrahman Bin Faisal University, AlKhobar, Kingdom of Saudi Arabia; 2College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia; 3Department of General Surgery, King Fahad Specialist Hospital-Dammam, Kingdom of Saudi Arabia; 4Department of Emergency Medicine, King Fahad Specialist Hospital-Dammam, Kingdom of Saudi Arabia; 5Department of Psychiatry, Ministry of Health, Dammam, Kingdom of Saudi Arabia; 6Mount Sinai Medical Center, Department of Emergency Medicine, Miami Beach, Florida, USACorrespondence: Nisreen H MaghrabyKing Fahd University Hospital-College of Medicine, Imam Abdulrahman Bin Faisal University, 6844 King Faisal University City, Dammam 3026-34211, Saudi ArabiaTel +966504807318Email nhmaghraby@iau.edu.saBackground: Whole-body computed tomography (WBCT) has been a mainstay and an integral part of the evaluation of polytrauma patients in trauma centers and emergency departments (ED) for a comprehensive evaluation of the extent of injuries. However, routine use of WBCT remains controversial since it exposes patients to radiation and exponentially increases financial expense. The primary objective was to determine the rate of negative WBCT in polytrauma patients.Patients and Methods: A retrospective cohort study was conducted at an academic hospital in the Kingdom of Saudi Arabia, which is a dedicated trauma center with a mean of 237,392 ED visits and 10,714 trauma per year. The study included all adult (≥ 18 years) polytrauma patients who presented to our ED, requiring trauma team activation, and underwent WBCT as part of their evaluation from January 2016 to May 2017. We excluded pediatric patients, patients transferred from another facility, and pregnant patients. The primary endpoint was to measure the rate of negative WBCT in polytraumatized patients.Results: A total of 186 patients were included with a mean age of 28.8 ± 12.9 years. The rate of negative WBCT scans was 20.4%. The positive scans were subclassified based on the number of anatomical body regions that were affected radiologically. One body region was affected in 47 patients (31.8%), two body regions were affected in 50 patients (33.8%), and ≥ 3 body regions were affected in 51 patients (34.3%). In a subset analysis, we identified that oxygen saturation < 94% and GCS ≤ 8 were associated with positive CT scans.Conclusion: Our study revealed a slightly higher rate of utilization of WBCT in the management of trauma patients compared to studies with similar practice. We believe that in the correct setting with incorporating high index of suspicion, a physical examination with attention to vital signs and mental status, performing E-FAST, and dedicated X-Rays is a way to potentially reduce the use of WBCT in polytrauma patients.Keywords: negative rate, whole-body, selective, computed tomography, multiple, polytrauma, MVCs

Adam F Aldhawyan, Ali A Alfaraj, Sara A Elyahia, Shaher Z Alshehri, Amal A Alghamdi Family and Community Medicine Department, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaCorrespondence: Adam F AldhawyanFamily and Community Medicine Department, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34221 – 4237, Saudi ArabiaTel +966 503 838700Fax +966 133330220Email aaaldhawyan@iau.edu.saIntroduction: Social media (SM) usage has increased markedly among young adults. It is linked to poor sleep quality (PSQ), a risk factor for mental and physical health concerns. This study identified the determinants of PSQ in SM users among freshman college students.Material and Methods: A cross-sectional design was used and 842 students completed a self-administered questionnaire. Analyses were performed using the χ2 test to examine differences in the characteristics of poor and good sleepers and logistic regression to estimate the risk of PSQ with reference to SM usage patterns.Results: Around 75.40% (n = 635) of the participants had PSQ. There was a significant difference in the PSQ rate between males (66.3%) and females (79.3%, p < 0.001), those who were physically active (67.2%) and those who were not (82.4%, p < 0.001), those who were mentally depressed (86.5%) and those who were not (61.5%, p < 0.001), and those with anxiety (87.8%) and those without (64.3%, p < 0.001). The risk of PSQ was lower among students who used SM for education (OR = 0.65, CI = 0.42 to 0.99, p = 0.048), had higher laptop usage (OR = 0.67, CI = 0.47 to 0.96, p = 0.03), and had higher SM usage during daytime (OR = 0.46, CI = 0.32 to 0.67, p < 0.001). The risk of PSQ was higher among those who reported SM usage at bedtime (OR = 1.69, CI = 1.01 to 2.81, p = 0.046).Discussion: Among SM users, PSQ was related to sociodemographic features, lifestyle characteristics, and health-risk factors. Further research is required to confirm these findings.Keywords: PSQI, sleep hygiene, social network, medical students, young adults, Saudi Arabia

Nouf F Bin Rubaian,1 Reem S AlOmar,2 Ahmed S Alzahrani,3 Faleh M Alotaibi,3 Mohammed A Alharbi,3 Bader S Alanazi,3 Serene R Almuhaidib,4 Nawaf F Alsaadoon,5 Dunya Alfaraj,6 Nouf A AlShamlan2 1Dermatology Department, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 3College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 4Department of Dermatology, Dammam Medical Complex, Dammam, Saudi Arabia; 5Department of Emergency, King Fahad University Hospital, Al-Khobar, Saudi Arabia; 6Emergency Department, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaCorrespondence: Nawaf F Alsaadoon, Department of Emergency, King Fahad University Hospital, Al-Khobar, Saudi Arabia, Email Nawafalsaadoon@gmail.comBackground: Numerous dermatological conditions present in the emergency department (ED). Some have subtle presentations, yet most provoke patient suffering. Such conditions need to be identified and managed properly. This study aims to epidemiologically describe the patterns and characteristics of dermatological conditions presenting to a secondary teaching hospital’s ED.Methods: This retrospective chart review study analyses data on dermatological conditions that have presented to the ED between January 2021 and May 2023. The data gathered included sociodemographic variables, date and shift of visit, triage level, dermatological complaint characteristics, management, and discharge status. Comparative analysis was performed, and the level of significance was set at 0.05.Results: The total number of cases was 301. The median age was 12 years (IQR = 4– 30 years), with similar distribution between males and females (50.17% and 49.83% respectively). Most cases had presented to the ED during the morning shift (49.83%). Triage levels IV and V made up 94.69%, and only 5.32% belonged to triage level III. Most presented during the winter season (32.89%). The median visit duration was 312 minutes, and of all cases treated, only 10 required a return visit to the ED. Also, 41.53% were discharged and 58.47% required further management. Maculopapular rashes were the most common finding (35.55%). Bullae/blisters and erythroderma accounted for those that most often required further management. The two most prescribed medications were topical steroids and antihistamines, followed by emollients (32.09% and 15.81%, respectively). Viral infections were the most reported complaint (22.26%) and only two patients complained of erythema multiforme (0.66%).Conclusion: This study found that the majority of cases could have been managed by family physicians at a primary care setting. Also, epidemiological seasonal variations were observed where the majority of patients requiring further management had presented during the autumn season.Keywords: epidemiology, dermatology, emergency department

Background: Nurses play a critical role in delivering healthcare services, and their perception of the quality of those services is critical to better patient care. This study aimed to capture nurses' perceptions of healthcare services in India. Materials and Methods: An exploratory study design was adopted. 554 nurses from selected public and private hospitals in Kerala, India, were randomly selected for the study. The data were analyzed quantitatively with SPSS 23.0. Results: The perception of nurses in all dimensions of the HQP is observed as high (>3.5), with the exception of their involvement in quality management, which is reported as medium (2.5–3.49). Further, a significant difference between public and private hospitals (p < 0.05) is observed for all variables, except for the perceived effectiveness of quality improvement (p = 0.81) and the availability of training and development opportunities (p = 0.80). Additionally, nurses working in accredited hospitals (mean = 3.78) have more positive perceptions than non-accredited hospitals (mean = 3.69) (p < 0.05). Female nurses show a significantly more positive attitude toward the quality of health services than their male colleagues. Conclusion: The participating nurses were aware of various aspects of the quality management systems in their respective hospitals. In addition, the public and private hospitals and the accredited and non-accredited hospitals differed in their quality practices, as reflected in the nurses' voices. This study would help healthcare policy planners enhance the quality of the public sectors in India. [ABSTRACT FROM AUTHOR]

AbstractThis study investigated the Mpox outbreak that occurred in a health cluster of three hospitals in Riyadh, Saudi Arabia, involving 97 patients diagnosed between May and December 2023. Among them, 48% were Saudi nationals, 94% were men, and 73% were under 35 years old. While sexual activity was a potential transmission mode, only 38% of patients reported it. All patients were presented with skin lesions and common symptoms like fever, headaches, and itching, with two being HIV positive. Genotyping revealed all samples were from subclade IIb (West Africa clade). Unlike previous outbreaks, rashes and systemic symptoms emerged simultaneously without a prodromal phase. Stringent infection control measures kept healthcare workers safe, although underreporting of sexual behavior may limit the study’s findings. This highlights the need for Mpox consideration in young individuals with skin lesions. [ABSTRACT FROM AUTHOR]

The emergence of multidrug-resistant fungi Candida auris is a worldwide health crisis connected with high rates of mortality. There is a critical need to find novel and unique antifungal compounds for treating infections of multidrug-resistant fungi such as C. auris. This study aimed to illustrate that biosynthetic gene clusters in native bacterial isolates are able to produce antifungal compounds against the multidrug-resistant fungus C. auris. It was successfully achieved using large-scale antifungal activity screening, cytotoxicity analysis, and whole genome sequencing integrated with genome mining-guided analysis and liquid chromatography–mass spectrometry (LC/MS). A list of possible gene candidates was initially identified with genome mining methods to predict secondary metabolite gene clusters of antifungal-compound-producing bacteria. Then, gene clusters present in the antifungal-compound-producing bacteria were identified and aligned with the reference genome using comparative genomic approaches. Bacillus halotolerans AQ11M9 was identified through large-scale antifungal activity screening as a natural compound-producer against multidrug-resistant C. auris, while it was nontoxic to normal human skin fibroblast cells (confirmed using a cell viability assay). The genome (4,197,347 bp) of B. halotolerans AQ11M9 with 2931 predicted genes was first mined for detecting and characterizing biosynthetic gene clusters, which revealed 10 candidate regions with antifungal activity. Clusters of AQ11M9 encoded non-ribosomal peptide synthase (NRPS) (bacilysin, bacillibactin, paenibactin, surfactin, plipastin, and fengycin) and polyketide (macrobrevin). The presence of gene clusters with anti-C. auris activity, and surfactin identified through LC/MS, from AQ11M9 suggests the potential of utilizing it as a source for a novel and powerful anti-C. auris compound. [ABSTRACT FROM AUTHOR]