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Background: Hemoglobin A1c (HbA1c) measures blood glucose over a period of 2–3 months, and its level is closely related to the risk of complications. Several factors affecting HbA1c levels have not been studied. This study mainly focused on the relationship between HbA1c levels and complete blood count (CBC) parameters. Objectives: This study aimed to analyze the relationship between HbA1c levels and CBC parameters in patients with type 2 diabetes mellitus (T2DM) and to evaluate the association of CBC parameters with abnormal HbA1c levels and diabetic complications. Methods: This was a retrospective study of 385 Saudi patients with T2DM aged ≥18 years attending King Khalid University Hospital (KKUH) primary care clinics. Patients with type 1 diabetes mellitus, hematological diseases, infections, or allergies were excluded. AnElectronic System for Integrated Health Information (e-SiHi)was used to collect data, which were analyzed using SPSS 22 using t-test and analysis of variance, with P

Background:Hemoglobin A1c (HbA1c) measures blood glucose over a period of 2–3 months, and its level is closely related to the risk of complications. Several factors affecting HbA1c levels have not been studied. This study mainly focused on the relationship between HbA1c levels and complete blood count (CBC) parameters. Objectives:This study aimed to analyze the relationship between HbA1c levels and CBC parameters in patients with type 2 diabetes mellitus (T2DM) and to evaluate the association of CBC parameters with abnormal HbA1c levels and diabetic complications. Methods:This was a retrospective study of 385 Saudi patients with T2DM aged ≥18 years attending King Khalid University Hospital (KKUH) primary care clinics. Patients with type 1 diabetes mellitus, hematological diseases, infections, or allergies were excluded. AnElectronic System for Integrated Health Information (e-SiHi)was used to collect data, which were analyzed using SPSS 22 using t-test and analysis of variance, with P Results:This study showed that the mean patient age was 59±13 years, with no significant difference between the sexes. In addition, the mean duration of disease was 10 years, and the mean HbA1c level was 8.5±1.9 %. CBC values were averaged according to their mean values, except for the erythrocyte sedimentation rate (ESR) (36±27 mm/hr) which was higher than the normal value (1.0–25 mm/hr). Conclusion:This study showed an association between HbA1c levels and duration of T2DM and hemoglobin. The progression of diabetic complications was related to CBC changes a high ESR was associated with the incidence of diabetic nephropathy and increased white blood cell count with neuropathy, vasculopathy, and nephropathy. Among all complications, vasculopathy occurred more frequently with each increase in HbA1c values. &nbsp

The purpose of this study was to investigate into mental health outcomes such as stress, anxiety, and depression, as well as sleep quality in suspected COVID-19 quarantined cases.This is a cross-sectional study that used an online survey to target suspected COVID-19 cases in quarantine facilities. Data were collected on several aspects of participants' sociodemographic characteristics, sleep disturbance, and mental health status. Depression, anxiety, stress scale and Pittsburgh Sleep Quality Index were used to measure both the psychological impact and mental health status.Of the 362 people who took the survey, 234 (64.6%) were men, and 148 were between the ages of 26-35. Poor sleep was found to be prevalent in 65% of study participants. The rates of individuals reporting severe depression, anxiety, and stress symptoms were 14.6%, 15%, and 15%, respectively. According to the findings, there were significant gender differences in depression and anxiety (p=0.001). When compared to the other age groups, participants aged 26-35 reported the highest level of stress (p=0.001). Being male [OR = -1.23, 95% CI (-2.75 - 1.95) P = 0.050], single [OR = 0.98, CI (0.15 - 4.20), P = 0.001], and a healthcare worker [OR = -2.20, 95% CI (-2.59 - 1.82), P = 0.001] were all associated with poor sleep quality.Approximately one-third of quarantine COVID-19 patients had poor sleep quality with mild-moderate depression. Both anxiety and stress scales were prevalent in nearly half of the studied samples.

Objectives: To assess sex differences in the prevalence of sarcopenia among pre-frail community-dwelling older adults in Saudi Arabia. Methods: This was a cross-sectional study conducted at a tertiary-level hospital in Riyadh, Saudi Arabia, in 2019. The study participants were pre-frail community-dwelling older adults, according to the Edmonton Frail Scale. The SARC-F questionnaire was used to diagnose sarcopenia. The Katz Activities of Daily Living (ADL) was used to rank the adequacy of performance in six functions: bathing, dressing, toileting, transferring, continence, and feeding, while the Lawton Instrumental Activities of Daily Living scale was used to assess the more complex ADL necessary for living in the community. Results: In total, 283 community-dwelling older adults were recruited for this study, with a mean (±SD) age of 70.77 (±6.26) years; 72.7% of the total were female participants. The majority (85.5%) of the patients reported that they needed home care assistance. The mean ADL score of the participants was high, indicating high function and independence (KATZ-ADL: M 4.60 SD 1.75; Lawton Brody: 60%). The overall prevalence of sarcopenia among the studied participants was 65.7%, which was significantly higher among females (71.9%) than among males (59.1%), with a P-value of 0.007. Among the demographic characteristics of the participants, there was a significant difference in the need for home care assistance in female sarcopenic and non-sarcopenic participants (74.1% vs. 25.9%, p = 0.017), but without demonstrable difference in males. Additionally, there was a significant difference (P

Objective In this cross-sectional study, we aimed to determine the association of self-care management practices and glycemic control of type 2 diabetes mellitus in Saudi Arabia. Methods A total of 352 type 2 diabetes mellitus (T2DM) patients from two public tertiary hospitals in Saudi Arabia participated in this study. All T2DM patients were recruited and interviewed by a researcher between January to April 2018 from the outpatient diabetes clinics. All respondents answered a four-part questionnaire which includes demographics data, Diabetes Self-Management Questionnaire (DSMQ). Linear Regression was performed to assess the significance of predictors and compute the coefficient of determination. Results The mean age of the participants was 51.89 ± 10.94. Of the 352 participants, 52% were obese (BMI: ≥30 kgm2) and 77% of the participants had glycated haemoglobin (HbA1c) over 7%. The analysis showed that subscale of Glucose management was the strongest predictor of Hba1c levels of participants’ followed by physical activity. Gender and marital status emerged as significant predictors for their self-care management practices. Female patients had more self-care management practices than male patients (B 0.20; 95CI 0.10– 0.96 (p = 0.015). Conclusion This study provides an evidence on the self-care management of T2DM patients in Saudi Arabia. The high self-care management found in the study highlights that the patients are aware of the severity of and possible complications associated with T2DM.

Background: Smoking is one of the leading risk factors that raised mortalities and morbidities significantly. Smoking cessations programs were implemented to reduce the number of smokers. Many factors may influence the smoking cessation including factors related to the treating physician. Objective: To determine smokers' perception and attitude towards smoking cessation when knowing the physician is a smoker. Methods: This was an observational cross-sectional survey study that has been conducted among smokers' patients at King Khalid University Hospital in Riyadh, the estimated sample size was 200 participants. Results: The participants who saw a smoking physician were 90% and 8.8% of them were supported by physicians to quit smoking. The remaining 10% participants reported that they did not see a smoking physician and 15.8% of them were supported by physicians to quit smoking. There was significant correlation between attitude toward smoking cessation and the smoking status and the highest score was found among current smokers and lowest score among ex-smokers (P-value= 0.012). Moreover, the score was highest among those who have history of failed attempt to quit smoking. Lastly, there was no statistically significant difference in scores based on perception and attitude towards smoking cessations when knowing the physician is a smoker. Conclusion: The present study assessed the level of perception and attitude among smokers and the results suggest a different impact of smoker physicians and compared it according to characteristics of smoking. Also, this study showed variations in the behaviors of smoking and cessation, smoking-related barriers that prevent patients from stopping smoking based on physician smoking status.

Objective: Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), remains a deadly infectious disease. India contributes to one-third of the global TB burden. However, no studies have been carried out in the Telangana (Hyderabad) population using real-time polymerase chain reaction (RT-PCR). Therefore, the current study evaluated the role of RT-PCR as a rapid and non-invasive test to diagnose TB by testing for pulmonary tuberculosis (PTB) and extrapulmonary tubercu- losis (EPTB). Materials and methods: This hospital-based study examined 1670 samples (900 EPTB; 770 PTB) comprising tissue (n = 537), peritoneal fluid (n = 420), sputum (n = 166), bronchial fluid (n = 126), cerebrospinal fluid (n = 145), ascetic fluid (n = 76), sputum pus (n = 78), urine (n = 79), and bronchoalveolar fluid (n = 43) samples. DNA from samples was separated using specific isolation kits and subjected to RT-PCR. Results: In this study, we enrolled 1670 subjects and categorized 54.4% as females and 45.6% as males. The collected sam- ples were categorized as 48.5% of fluid samples, followed by tissue (32.2%), sputum (9.9%), urine (4.7%), and pus-swab (4.6%). RT-PCR analysis revealed that 4.7% patients were positive for Mtb. Our results revealed that 61% of the affected patients were male and 39% were female. Among the specimen types, tissue samples gave the highest proportion of positive results (36.3%). Conclusion: The results showed that RT-PCR should be implemented and given top priority in TB diagnosis to save time and facilitate a definitive diagnosis. Tissue samples are highly recommended to screen the Mtb through the technique RT- PCR. Future studies should extend the technique to the global population and exome sequencing analysis should be per- formed to identify TB risk markers. Keywords: Tuberculosis (TB); EPTB; PTB; Mycobacterium tuberculosis (Mtb).

Nawaf A Alshammari,1,2,&ast; Abdulaziz A Alodhayani,3,&ast; Salini S Joy,4 Arthur Isnani,5 Muhammad Mujammami,1,4,6 Assim A Alfadda,4– 6 Khalid Siddiqui4 1University Diabetes Center, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia; 2King Salman Specialist Hospital, Diabetes and Endocrine Center, Hail Health Cluster, Hail, Hail Region, Saudi Arabia; 3Department of Family and Community Medicine College of Medicine, King Saud University, Riyadh, Saudi Arabia; 4Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 5Obesity Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 6Department of Medicine, College of Medicine, and King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia&ast;These authors contributed equally to this workCorrespondence: Khalid Siddiqui, Strategic Center for Diabetes Research, College of Medicine, King Saud University, P.O. Box 245, Riyadh, 11411, Saudi Arabia, Email ksiddiqui@ksu.edu.saBackground: Neuropathy is the most common microvascular complications among diabetic patients. Diabetic peripheral neuropathy (DPN) is the predominant variety which may associate with increased in mortality and morbidity among type 2 diabetes mellitus (T2DM).Objective: To assess the prevalence of diabetic peripheral neuropathy and its correlation with risk factors among T2DM.Methods: This was a cross-sectional retrospective study, data was collected from a previous cohort study conducted at the University Diabetes Center, King Saud University Medical City (KSUMC), King Saud University, Riyadh, Saudi Arabia. The data of T2DM patients were collected from case report form, included demographic data, history of chronic diabetes neuropathy, and laboratory reports. Statistical analysis includes Student`s t test, chi square test, and Pearson correlation and logistic regression were performed.Results: A total of 430 patients with T2DM data was collected and analyzed, and of them 54% were females, with the mean age of 55.88 years. The prevalence of diabetic neuropathy among study participants were 40.2%, and 73.3% of them having the subtype polyneuropathy. The mean BMI; p = 0.006, FBS; p < 0.001, HbA1c; p < 0.001, cholesterol p = 0.001, LDL; p < 0.001, and triglyceride; p < 0.001 levels were a significantly higher among participants with diabetic neuropathy than without neuropathy. The male gender (Risk Ratio: 1.294, 95% CI:1.090, 1.536) p = 0.003, fasting blood glucose (Risk Ratio: 1.157, 95% CI:1.051, 1.273) p = 0.003 Cholesterol (Risk Ratio: 1.588, 95% CI:1.174, 2.147) p = 0.003, triglyceride (Risk Ratio: 1.290, 95% CI:1.086, 1.538), p = 0.004, and LDL (Risk Ratio: 1.299, 95% CI:1.073, 1.574), p = 0.007) were found to be significant risk factors for DPN.Conclusion: DPN is highly prevalent among T2DM patients in Saudi Arabia. Poor glycemic control and hyperlipidemia were associated with significantly higher risk for DPN patients among T2DM.Keywords: diabetic peripheral neuropathy, hyperlipidemia, glycemic control, type 2 diabetes

Objective: This study aims to identify the prevalence of aspirin use among type 2 diabetic (T2DM) patients and assess the concordance in aspirin use among these patients as prescribed by physicians and as recommended by the Aspirin-Guide app. Methods: A total of 301 T2DM patients from King Khalid University Hospital in Riyadh, Saudi Arabia participated in this cross-sectional study. Patient’s electronic medical records through eSihi system were reviewed and all data included in the free online and mobile app called Aspirin-Guide were collected in a specially designed data checklist. Result: The prevalence of aspirin use was more common in patients who were in the age group of 51 to 59 and male participants’ with T2DM. Males were nearly twice more likely to use aspirin compared to females ( P = 0.001). Based on recommendations from the Aspirin-Guide app, 26% of the patients who were on aspirin (N = 51) were not eligible for aspirin therapy, while 37.7% (N = 40) of the patients eligible for aspirin therapy had not been put on aspirin by their physicians ( P = 0.039). Male sex ( P = 0.003), use of statins ( P = 0.001), and being advised to use aspirin ( P = 0.041), were significantly associated with aspirin use in T2DM patients. Conclusion: There was a significant difference in the proportion of patients currently on aspirin as prescribed by their physicians and those eligible for aspirin therapy as per the Aspirin-Guide app. The use of an app to uniformized aspirin use among eligible patients should be based on up-to-date guidelines and account for patient acceptability and willingness to commence treatment.

Objective: Diabetic quality indicators are missing a major part of diabetes care management. We aimed to explore the diabetic patients' knowledge of oral health care and identify the periodontal health status among them. Materials and Methods: This study was a cross-sectional study on diabetic patients at a diabetic care clinic in the primary care setting. Data collection instrument was structured to measure knowledge and dental hygiene practice. Clinical examination was done to assess dental health using the Simplified Oral Hygiene Index (OHI-S) and Periodontal Screening and Recording. Data were analyzed using Statistical Package for the Social Sciences (SPSS 22). Results: One hundred and ninety-five individuals were included in the study, with a mean age of 54.32 ± 11.58. Knowledge assessment showed that 47.2% of the respondents answered ≥50% of the questions. Dental hygiene behavior showed that 58.6% brushed teeth one to two times per day, 66.8% never used flossing, and 14% never visited a dental care clinic. Forty-seven individuals had dental examination. The mean OHI was 1.71 ± 1.06. The relationship between OHI and glycated hemoglobin, fasting blood sugar, diabetes duration, brushing, flossing, and vegetable and fruit consumption could not be detected with P= 0.61, 0.78, 0.93, 0.97, 0.86, 0.98, and 0.7, respectively. Patients' perception of dental health status is positively correlated with the clinical dental examination and statistically significant with P= 0.004. Conclusions: Oral health literacy should be improved with implementation of educational intervention. A positive correlation between patient perception and dental examination will help the health-care provider in diabetic care adoption of oral health care within diabetic management at the primary care setting, which will improve the quality of diabetic care.

ObjectiveThis study investigated the prevalence of substance use (SU), and its risk factors, among women attending psychiatric outpatients center in Saudi Arabia.DesignA retrospective cross-sectional design.Materials and methodsWe reviewed outpatients’ records of 200 female patients with a history of SU from a psychiatric unit in Jeddah, Saudi Arabia from December 2018 to February 2019. The researchers developed the pro forma, and 2 psychiatrists and a family medicine physician validated the form.ResultsThe most common and widely used were psychoactive substances (58%), followed by central nervous system (CNS) depressants (22%), and finally cannabinols (9.5%). Overall, the highest substance use was the amphetamine-cannabis-nicotine (ACN) representing nearly half of the illicit items (46.6%), followed by heroine-alcohol-benzodiazepine (16.4%), and with the lowest being benzodiazepine-nicotine (1.7%). There was a significant difference between the single substance and multiple substance use in terms of age (p = 0.001), smoking behavior (p = 0.001), patients past history (p = 0.005), and age of the patient at the start of drug use (p = 0.005).ConclusionAlthough the prevalence of substance use among women is low in Saudi Arabia, screening of substance use disorders risks and building a rehabilitation program to control drug dependence are needed.

Summary: Assessment and treatment pathways based on age-specific intervention thresholds in Saudi Arabi can be used to identify patients at high risk of fracture and avoid unnecessary treatment in those at low fracture risk. Purpose: Intervention thresholds for the treatment of osteoporosis have historically been based on the measurement of bone mineral density. The aim of the present study was to explore treatment paths and characteristics of women eligible for treatment in Saudi Arabia based on fracture probabilities derived from FRAX®. Methods: The approach to the setting of intervention and assessment thresholds used the methodology adopted by the National Osteoporosis Guideline Group for FRAX-based guidelines in the UK but based on the epidemiology of fracture and death in Saudi Arabia. The methodology was applied to women age 40 years or more drawn from a tertiary referral population for skeletal assessment. Missing data for the calculation of FRAX was simulated using data from the referral and FRAX derivation cohorts. Results: Intervention thresholds expressed as a 10-year probability of a major osteoporotic fracture ranged from 2.0% at the age of 50 years increasing to 7.6% at the age of 70 years. A total of 163 of 1365 women (11.9%) had a prior fragility fracture and would be eligible for treatment for this reason. An additional 5 women were eligible for treatment in that MOF probabilities lay above the upper assessment threshold. A BMD test would be recommended for 593 women (43.4%) so that FRAX could be recalculated with the inclusion of femoral neck BMD. Of these, 220 individuals would be eligible for treatment after a BMD test and 373 women categorised at low risk after a BMD test. Conclusion: Probability-based assessment of fracture risk using age-specific intervention thresholds was developed for Saudi Arabia to help guide decisions about treatment.

Background: The negative psychological impact of COVID-19 in the general population has been well documented. Similar studies among those who were infected and who underwent quarantine remain scarce, particularly in the Arab region. The present study aims to fill this gap. Methods: In this cross-sectional study, suspected/confirmed COVID-19 individuals who were quarantined in the Ministry of Health (MOH) facilities were invited to participate in an online survey. All consenting participants answered a generalized questionnaire that included demographic characteristics, as well as a five-part questionnaire that assessed the symptoms of depression, anxiety, insomnia, and distress. Results: A total of 335 suspected/confirmed COVID-19 individuals (198 males and 137 females) participated. Being female is associated with increased risk of depression (odds ratio OR 1.8 (confidence interval, CI 1.1–3.1, p = 0.03)) as well as being employed by the government (OR 2.8 (CI 1.1–7.0, p = 0.03)). Level of education (OR 2.3 (CI 1.0–5.4, p = 0.049)) and employment in government (OR 3.0 (CI 1.2–7.8, p = 0.02)) were significantly associated with distress. Increasing age (45 years and above) appeared to be protective against distress (OR 0.2 (CI 0.02–0.69, p = 0.008)), as well anxiety and sleep pattern (OR 0.3 p &lt, 0.05). Conclusion: Findings of the present study highlight that infected COVID-19 populations are at higher risk for acute and detrimental psychological well-being during quarantine and/or self-isolation. Identification of the coping mechanisms of older adults during periods of distress may prove beneficial in the pandemic preparedness of younger generations.

ObjectiveTo compare gender differences in pain management among adult cancer patients in Saudi Arabia and to explore the predictors associated with attitudinal barriers of cancer patients to pain management.MethodsA descriptive cross-sectional study was conducted among 325 cancer patients from tertiary hospitals in Saudi Arabia.ResultOf the total participants, 67.4% were women (N = 219) and 32.6% were men (N = 106). The overall mean scores of the attitudinal barriers questionnaire were 49.51 ± 13.73 in men and 54.80 ± 22.53 in women. The analysis shows significant differences in scores in subscales of tolerance (men = 7.48 ± 2.37), (women = 8.41 ± 3.01) (p = 0.003) and fear of distraction in the course of treatment (men = 6.55 ± 1.34), and (women = 7.15 ± 2.63) (p = 0.008). Female patients reported a more moderate to severe level of pain than men (worst pain in last week of 7.07 ± 1.50, worst pain in last week of 5.84 ± 2.65, respectively). Splitting by gender, the significant predictor for physiology effect domains in male cancer patients includes age, marital status, employment status, monthly income, cancer type, and presence of comorbid disease (p < 0.050). Age was a significant predictor of the domains of fatalism, communication, and harmful effects (p < 0.050) among female cancer patients.ConclusionThe present study revealed significant differences between men and women with attitudinal barriers to cancer pain management. Managing pain requires the involvement of all methods in a comprehensive manner, thus unalleviated pain influences the patient’s psychological or cognitive aspect.

Most clinical investigations about the impact of nanoparticles on cells and tissues show that nanoparticles may enter the human body by means of respiratory tracts. Humans, animals, plants and environments are continually presented to a wide scope of business items containing silver nanoparticles (Ag NPs) in their piece. Ag NPs, utilized in various consumer products as room showers, surface cleaners, wound dressings, food storage containers and many textiles. The current examination planned to explore the defensive role of Avenanthramide-C (Avns) contrary to the lung toxicity initiated by Ag NPs injection in rats. 40 male Wistar rats were separated into 4 groups (Gp1, control; Gp2, Avns; Gp3, Ag NPs; Gp4, Ag NPs+Avns). Current results revealed that; Ag NPs induced a significant depletion in RBCs count, hemoglobin, platelets counts and a significant increase in total WBCs, lung injury, cyclooxygenase-2 (COX2) and TNFα expressions as compared to control. Treatments of Ag NPs with Avenanthramide-C extract (Ag NPs+Avns) improved the lung structure and blood complete pictures as compared to Ag NPs group.

Assessment and treatment pathways based on age-specific intervention thresholds in Saudi Arabi can be used to identify patients at high risk of fracture and avoid unnecessary treatment in those at low fracture risk.Intervention thresholds for the treatment of osteoporosis have historically been based on the measurement of bone mineral density. The aim of the present study was to explore treatment paths and characteristics of women eligible for treatment in Saudi Arabia based on fracture probabilities derived from FRAX®.The approach to the setting of intervention and assessment thresholds used the methodology adopted by the National Osteoporosis Guideline Group for FRAX-based guidelines in the UK but based on the epidemiology of fracture and death in Saudi Arabia. The methodology was applied to women age 40 years or more drawn from a tertiary referral population for skeletal assessment. Missing data for the calculation of FRAX was simulated using data from the referral and FRAX derivation cohorts.Intervention thresholds expressed as a 10-year probability of a major osteoporotic fracture ranged from 2.0% at the age of 50 years increasing to 7.6% at the age of 70 years. A total of 163 of 1365 women (11.9%) had a prior fragility fracture and would be eligible for treatment for this reason. An additional 5 women were eligible for treatment in that MOF probabilities lay above the upper assessment threshold. A BMD test would be recommended for 593 women (43.4%) so that FRAX could be recalculated with the inclusion of femoral neck BMD. Of these, 220 individuals would be eligible for treatment after a BMD test and 373 women categorised at low risk after a BMD test.Probability-based assessment of fracture risk using age-specific intervention thresholds was developed for Saudi Arabia to help guide decisions about treatment.

Vast majority of mediastinal goiters are situated in the anterior mediastinal compartment and rarely located in the posterior mediastinum. Posterior mediastinal goiters should be differentiated from other mediastinal masses through appropriate work-up by the computed tomography which is the most valuable technique. We reported a case of symptomatic mediastinal goiter extending from the neck to the posterior mediastinum compressing the trachea and airway. The surgical intervention is considered the treatment of choice in such cases. The surgical approach was done through a classical transverse cervical incision, lateral right thoracotomy, and median sternotomy. The histopathological report was consistent with a multinodular goiter. The patient's recovery was uneventful with an excellent postoperative symptomatic relief.

Background In the Kingdom of Saudi Arabia, the 2016 Census indicated that there were more than 1 million people aged 65 years and older, representing 3.3% of the population. Increased life expectancy will lead to a significant increase in the elderly population in the Kingdom of Saudi Arabia by 5-fold (18%) in 2050. Aim This study aimed to measure internal medicine and family medicine residents' attitudes toward elderly patients and evaluate their interest in and barriers to geriatric medicine at King Saud University Medical City. Method A cross-sectional observational analytical study using a convenient sampling method was performed in the internal medicine and family medicine departments at King Saud University Medical City, Riyadh, Kingdom of Saudi Arabia, from April 2017 to August 2017. The total sample size was 101 residents. Data were collected via an online survey using a predesigned validated questionnaire (University of California at Los Angeles Geriatrics Attitudes Scale). Results The results showed a neutral attitude of both family and internal medicine residents with p=0.9 and p=0.6, respectively, without any significant association with their training levels. Moreover, this study showed that 87% of the residents were not willing to consider geriatric medicine as a subspecialty due to the unavailability of a local geriatric training program (59.5%), whereas the cognitive capacity of the patients was the least barrier chosen by the residents (4.8%). Conclusion Based on the findings of this study, most of the participants did not receive training in geriatric medicine, which mandates the need for early exposure to geriatric training in medical schools and the need to integrate this type of training within the major postgraduate training programs of the Saudi Commission for Health Specialties .

Background Cancer patients under psychological distress have reduced compliance with treatment and prolonged hospitalizations. Identifying cancer patients who may be more likely to suffer from psychological distress over the disease trajectory is essential to targeting the proper interventions and providing the best care. In this descriptive cross-sectional study, we aim to assess the levels of emotional and physical distress, depressive symptoms, and social concerns of cancer patients undergoing radiotherapy treatment in Saudi Arabia. Methods A total of 148 cancer patients undergoing radiotherapy from five different public tertiary-level hospitals in Saudi Arabia participated in this study. The survey was conducted by a trained researcher from November 2015 through April 2016. The Psycho-Oncology Screening Tool was used to identify levels of distress of cancer patients undergoing radiotherapy. Emotional and physical distress, depressive symptoms, and social concerns in receiving psychosocial services were assessed. Results The findings show above average levels of physical and emotional distress was (342.07±78.9) and social concerns was (7.27±1.68). Age was a significant predictor of psychological distress and in social concerns (P

Background: Research activity represents an important process conducted to address an issue in a precise and systematic manner. Data of this kind regarding the methodological difficulties encountered by healthcare practitioners in conducting clinical research in Saudi Arabia are scarce. This study aims to assess the methodological difficulties encountered by healthcare practitioners in conducting clinical research in Saudi Arabia. Materials and Methods: This cross-sectional survey was conducted among healthcare practitioners who conducted or who were involved in research in Saudi Arabia from June 2018 through August 2018. Data were collected through SurveyMonkey, using a modified version of a questionnaire from a previous similar study. Results: Overall, 236 respondents participated in the study, more than half, that is, 131 (55.50%) had conducted research as principal investigators, 41 (17.40%) had never attended a research workshop, and 57 (24.20%) were members of research committees. Respondents identified “formulating the research title” and “cooperation between research partners” as the easiest research steps by 58 (24.58%) for each. “Receiving funds and financial resources to complete the research project” ranked the highest difficult step by 124 (52.54%) of the respondents. Attending >2 clinical research workshops was significantly associated with lower methodological difficulty scores. Specifically, those who attended scored 35.28 ± 12.86, while those who did not scored 42.34 ± 12.64, with a highly statistically significant difference (P = 0.001). Conclusion: These findings show that securing funding and finding an available biostatistician contributed greatly to the methodological difficulties of conducting clinical research. The difficulty score decreased significantly with increasing the number of clinical research workshops attended by the researchers.

Aljohara S Almeneessier,1,2 Nada A AlYousefi,1,2 Lemmese F AlWatban,1,2 Abdulaziz A Alodhayani,1,2 Ahmed M Alzahrani,1,2 Saleh I Alwalan,1 Samaher Z AlSaad,1 Anas F Alonezan1 1Department of Family and Community Medicine, College of Medicine, King Saud University (KSU), Riyadh, Kingdom of Saudi Arabia; 2King Saud University Medical City, King Saud University, Riyadh, Kingdom of Saudi ArabiaCorrespondence: Aljohara S AlmeneessierDepartment of Family and Community Medicine, College of Medicine, King Saud University (KSU), Riyadh, Kingdom of Saudi ArabiaTel +96611505274489Email aljoharas@yahoo.comBackground/Objectives: Practicing independently in an ambulatory care setting demands mastering the knowledge and skills of commonly performed minor procedures. Educational hands-on activities are one way to ensure competent family medicine practitioners. This study aims to evaluate a minor procedure workshop for family medicine trainees using the Kirkpatrick model for short- and long-term workshop effectiveness and to identify facilitators and obstacles faced by the trainees during their practices to gain procedural skills.Methods: A cross-sectional study was conducted in four-time intervals: during the workshop (pre- and post-workshop), 12 weeks after the workshop to evaluate the short-term effectiveness and change of behavior, and 12 months after the workshop to evaluate the long-term effectiveness of the workshop. Statistical Package for Social Sciences 22 was used for data analysis.Results: Forty postgraduate trainees (R1-R4) attended the workshop and participated in the survey. Overall, the workshop was accepted and highly perceived by the trainees, and the pre-workshop confidence level was lower than the post-workshop confidence level. The workshop met the expectation of 100% in obstetric and gynecological procedures workshop with 97% satisfaction rate, followed by dermatology (97.5%, 90%), orthopedic (95%, 87%), general surgery (97.5%, 84%), combined ophthalmology and otorhinolaryngology workshop (82.5%, 74%). At 12 weeks, 24 postgraduate trainees (R2–R4) responded to the survey, and low competency occurred with uncommon procedures in practice. At 12 months only 16 trainees (R3–R4) responded to the survey. Learning effect was higher as post-workshop and varied with the passage of time. Changes in the competency level were noticed, with the number of procedures performed being not statistically significant (P> 0.05).Conclusion: Practicing family medicine in an ambulatory health-care setting safely needs the mastering of minor office procedure skills. Evaluating educational workshops is important to ensure effective outcomes and identify the factors of trainees, supervisors, institutions, and patients that influence or hinder the performance of minor procedures in a family medicine clinic.Keywords: educational activity, evaluation, family practice, minor procedures, simulation