Search

Several factors are linked with a higher risk of mortality from Coronavirus disease-19 (COVID-19), including male gender, increased age, hypertension, diabetes mellitus, obesity, cardiovascular diseases, chronic obstructive pulmonary disease, and cancer. Hyperglycemic COVID-19 patients have severe clinical problems, increased ICU admittance, machine-driven ventilation, and a substantial rise in inflammatory markers. Among all patients, those with diabetes or hyperglycemia have a two- to four-fold increase in mortality and severity of COVID-19 than those without diabetes. The primary cause of mortality in COVID-19 patients with diabetes is compromised immune response to viral infections. Increased blood sugar level probably affects intracellular degradation of bacteria, neutrophil chemotaxis, and phagocytosis, thus improving viral binding affinity and entry and decreasing virus clearance. In addition, it has significant effects on the proteins by inducing glycosylation and altering the composition of complements, and glycosylation renders cells susceptible to viral inflammation and damage. The treatment of COVID-19 in patients with diabetes requires an integrated team approach to minimize the risk of medical complications and mortality. Moreover, physicians should adopt proactive strategies to care for persons with comorbidities. This strategy would help reduce the frequency of complications and mortality among patients and load on the healthcare system.

Depression is one of the commonest psychiatric disorders and is a prominent reason for major health problems worldwide. The prevalence and the dysfunction, morbidity, suffering, and economic burden. Depression can lead to upsurge in the health-seeking performance, diminished excellence of life and increased propensity for desperate tendencies. In the majority of the cases, the affected patients report late and owing to various scales of assessing depression, patients with depressive disorder are often undertreated. As per the Global Burden of Disease report the prevalence of depression is 1.9% among men and 3.2% for women and the overall one-year prevalence increases to 5.8% in men and 9.5% in women. Given the existing epidemiological evolution and demographic, the impact of unhappiness can be tremendous by 2020 with the burden of depression at about 5.7% of all the illnesses. The morbidity bearing will be so huge that and it would be the most important reason for disability-adjusted life years (DALYs), next only to ischemic heart disease. This education expected at to assess the prevalence and correlates of depression among type 2 diabetes mellitus patients and impact of treatment on diabetic status, glycemic quality and control of life after 6 months. The scales used in this study was Mini international neuropsychiatric interview – 6.0 , Hamilton Depression Scale (HAM-D), WHO Quality Of Life (WHO-QOL) – BREF scales, Morisky 8-item Medication Adherence Questionnaire. The study has highlighted the prevalence of depression in the study population, positive impact of depression on the treatment compliance, glycemic control and quality of life of the affected patients.

Vitamin D has long been known for preserving bone and non-skeletal health. Despite its magnitude of impact, scarce literature has explored the evolution of the relevant published literature. This study aimed at evaluating the trends and performance of Vitamin D and bone metabolism-related publications (2001–2020). All pertinent English language 16,887 articles were searched and extracted from the Web of Science (WoS) database and “R-Bibliometrix” was used for comprehensive analysis. Around 60,149 authors contributed from 114 countries, showing the USA on top with >1/4th of all articles, followed by Japan, China, and the United Kingdom. For authors, Cooper C, Dawson-Hughes B, and Holick MF were found to have written the most articles, citations and highest h-index, respectively. Corresponding authors from the top 20 countries collectively were responsible for around 84% of the articles. Among 2735 sources, Osteoporosis International (632), Journal of Bone and Mineral Research (569), and Bone (448) were foremost. Most prominent sources showed recent declining contributions. The increasing trend of publications with a higher spike from 2008 to 2014, followed by a gradual increase till 2017, was observed. Leading countries, affiliations, and authors showed collaborative publications and were mostly from developed countries with limited contributions, particularly from low- and middle-income countries.

The Drug Abuse Screening Test-10 (DAST-10) is a valid and reliable screening tool for drug use-related problems, however there is no Arabic version. To our knowledge, this is the first study to develop and validate an Arabic DAST-10 version. Saudi young adults participated in the study as two groups; drug users (n=360) recruited from Alamal Complex for Mental Health, Jeddah, and drug non-users (n=100). Three measures were used: (1) Demographic and drug use description questionnaire, (2) Arabic DAST-10 version, and (3) Urine analysis for drug use. The developed Arabic DAST-10 version demonstrated adequate internal consistency. High correlations were shown between its scores and the two standard measures (urine analysis and self-reporting question) indicating good criterion validity. Sensitivity and specificity values were between 91.5 - 99.7% and 57 - 92.5% with different DAST-10 cutoff values. An optimal performance at a cutoff score of 3 or more was most likely to significantly identify drug users. Discriminant analysis showed that more than 90% of cases were correctly classified. Distribution of participants in categories of DAST-10 scores according to degree of problems was reasonable. It is concluded that the developed Arabic DAST-10 version is a reliable and valid screening tool for drug use-related problems in Arabic speakers.

In our society, people’s health behaviors are considered a dilemma that can intensify the probability of developing a disease in the future. This study aimed to investigate the association between health risk behaviors and depression among a sample of university students, Karachi, Pakistan. A self-reported health behavior questionnaire was distributed to 813 consented students. The Center for Epidemiological Studies-Depression (CES-D-10) questionnaire was used, a short, self-report scale that measures the recent level of depressive symptomatology, primarily focusing on depressed mood. Their results were further compared with some important health behaviors and social activities. At the univariate stage, the chi-square test was executed to compare the characteristics of categorical variables with depression status. The effect size was measured in terms of the odds ratio (OR) using logistic regression models. According to the adopted classification of CES-D, one out of eight students were found to be depressed. Among students’, females were found to be 70% more depressed than males (OR: 1.7, 95% CI: 0.9–3.0). Depression was higher among students who were not satisfied with their lives, were socially isolated, had trouble sleeping, little control over things, and the future depends on others. The chances of depression were 90% higher among students who did not share private concerns with others (P = 0.01). Overall, depression prevalence was 12.5%, and it was associated with dissatisfaction with life, social isolation, insomnia, and others. Female students were found to be more depressed compared to males.

Purpose To find out the association of dyslipidemia and comorbidities with risk factors among type-2 diabetes mellitus (T2DM) patients attending King Abdulaziz University Hospital (KAUH) Jeddah, Saudi Arabia (SA). Patients and Methods Three hundred and twenty-five T2DM patients were enrolled from the electronic record of the KAUH. The patients' existing comorbidities and dyslipidemia correlation with demographic, clinical, and available laboratory data were sought. Statistical analysis was performed on SPSS-23. Results Of the total 325 T2DM patients with a mean age of 60.13±10.5 years [males 95 (29.23%) and females 230 (70.77%)] were included from the electronic record. Poor glycemic control was observed in 222 (68.31%) subjects (HbA1c > 7%), and 154 (47.39%) subjects had DM for more than ten years. Among our study subjects, 103 (31.69%) were hypertensive (HTN), 112 (34.46%) had ischemic heart disease (IHD), 45 (13.85%) were obese, 8(2.46%) had a stroke and 269 (82.77%) had dyslipidemia. Of the total 269 dyslipidemic patients,168 (62.45%) were on hypolipidemic treatment. On comparison of study variables according to dyslipidemia versus normal lipid levels, the lipid profile, including HDLc, LDLc, TC, and TG, revealed a highly significant difference (p-value

Objectives: To investigate adipocytokines’ (vaspin, omentin-1, and adiponectin) correlation with metabolic phenotypes in type 2 diabetes mellitus (T2DM) patients. Methods: This case-control research was done at the Diabetic Clinic in Jeddah, Kingdom of Saudi Arabia (KSA), from November 2018 to March 2019. Seventy-five T2DM patients and 75 gender, age, and BMI-matched healthy subjects were recruited for this research. Results: In DM patients, the concentrations of serum vaspin and omentin-1 were substantially lower (p25, and no gender-wise variance was observed in adipocytokines levels. Binary logistic regression analysis showed a significantly negative predictive relationship of vaspin and omentin-1 with DM. Conclusion: The DM group displayed substantially lower serum vaspin and omentin-1 levels. However, there was no consistent relationship observed between these adipocytokines and metabolic phenotypes. doi: https://doi.org/10.12669/pjms.37.7.4330 How to cite this:Baig M, Gazzaz ZJ, Bakarman MA, Alzahrani SH. Correlation of Serum Vaspin, Omentin-1, and adiponectin with metabolic phenotypes in Type-2 diabetes mellitus patients. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4330 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Zohair J Gazzaz Department of Internal Medicine, Faculty of Medicine, Rabigh, King Abdulaziz University, Jeddah, Saudi ArabiaCorrespondence: Zohair J GazzazDepartment of Internal Medicine, Faculty of Medicine, Rabigh, King Abdulaziz University, Jeddah, Saudi ArabiaTel + 966 505664144Email zjgazzaz@kau.edu.saPurpose: This study aimed to investigate knowledge, attitudes, and practices regarding diabetes mellitus (DM) among university students.Material and Methods: This cross-sectional study was carried out at the Faculty of Medicine, Rabigh, King Abdulaziz University (KAU) Jeddah, Kingdom of Saudi Arabia (KSA), in 2018. All participants were the registered students at the foundation year in the branch of KAU, Rabigh. A questionnaire was developed that had questions related to knowledge, attitudes, and practices.Results: A total of 1428 participants (770 [53.9%] females and 658 [46.1%] males) were included in the study. Surprisingly, there were 315 (22.1%) students who had been diagnosed with hypertension or told by the healthcare professional that he/she has increased blood pressure, and 223 (15.6%) had high blood sugar. There were 785 (55%) participants who had one or more DM relative. Among our students, only 186 (13%) had good knowledge scores, while 569 (39.8%) and 673 (47.1%) had moderate and poor knowledge scores, respectively. Interestingly, 1190 (83.3%) participants had positive attitudes, while 238 (16.7%) had negative attitudes. More than half of the participants, 844 (59.1%), were practicing adequately for preventing DM. It was observed that females had significantly better general knowledge about DM, its risk factors, signs and symptoms, control and management, complications, and total knowledge scores. Our results showed that the female gender was associated with good knowledge and positive attitude and relatives diagnosed with DM were associated with good knowledge score. The participants who had DM relative and hypertension were more likely to have good attitudes and practices, respectively, in preventing DM.Conclusion: Our students’ knowledge score was not up to the mark. Interestingly, participants had positive attitudes and practicing adequately for preventing DM. The female gender was associated with good knowledge scores and positive attitudes.Keywords: diabetes mellitus, awareness, attitude, practice, students

Objective: To determine the association of serum omentin-1, chemerin, and leptin with acute myocardial infarction (AMI) and its risk factors among individuals admitted with AMI to the coronary care unit (CCU). Methods: The current case-control study was conducted at the CCU of King Abdulaziz University Hospital (KAUH), Jeddah, Kingdom of Saudi Arabia (KSA), in 2016-2018. A total of 122 AMI patients admitted to CCU, and 52 BMI and age-matched healthy subjects, between 30 and 65 years of age, were included. Results: Chemerin and omentin-1 are independent predictors of the incidence of MI. Furthermore, serum omentin-1 was significantly lowered while chemerin and hsCRP levels were found to be significantly raised among the individuals with AMI compared to the healthy subjects, and no notable change was found in the serum leptin level. Serum omentin-1, chemerin, and leptin were significantly correlated with weight, BMI, waist circumference in patients, and control subjects. Binary logistic regression analysis displayed that the occurrence of MI is positively correlated with fasting plasma glucose (FPG), TC, TG, LDL-C, hsCRP, and chemerin and in a negative manner with HDL-C, and omentin. The chemerin and omentin-1 were also linked with the MI in multiple logistic regression analysis. Conclusions: The present results indicated that the serum omentin levels were significantly lowered while chemerin and hsCRP levels were found to be markedly raised among patients. No change was found in serum leptin levels. Serum chemerin and omentin-1 levels were independently associated with the MI. It appears that these parameters may be used to assess the risk spectrum of CAD. doi: https://doi.org/10.12669/pjms.36.6.2372 How to cite this:Baig M, Alghalayini KW, Gazzaz ZJ, Atta H. Association of Serum Omentin-1, Chemerin, and Leptin with Acute Myocardial Infarction and its Risk Factors. Pak J Med Sci. 2020;36(6):1183-1188. doi: https://doi.org/10.12669/pjms.36.6.2372 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

In the world scenario, the advent of COVID-19 has halted every aspect of life. It influenced every field of life, including the economy, and revealed the inadequacies in all nations' healthcare systems, from the most developed to the underdeveloped countries. There is a debate about the timing of antibodies production and detection during the disease. What is the significance of reverse transcription-polymerase chain reaction (RT-PCR) viral ribonucleic acid (RNA) in symptom resolving period? In the present manuscript, we have evaluated these points.

BACKGROUND NA OBJECTIVE NA METHODS NA RESULTS NA CONCLUSIONS NA CLINICALTRIAL NA

This study aimed to investigate the prevalence and attitude of university students towards mobile phone use while driving. The present study was conducted at King Abdulaziz University, Jeddah, Saudi Arabia. Five hundred and ninety-three participants were recruited for this study. Attitude, consequences and their involvement in various reckless behaviours pertaining to the use of mobile phone while driving were checked by a questionnaire. Overall, the majority of the respondents (90%) use a mobile phone while driving. About half of the participants had experienced consequences regarding texting while driving and had engaged in reckless behaviour. The majority of the students of Faculty of Medicine, Engineering Sciences, Earth Sciences, Administration and Economics and Orientation Classes were more frequently texting while driving (p < .001). The unmarried students were more often texting while driving as compared to married (p < .001). Overall, the majority of the respondents use the mobile phone while driving.

Objective: To explore the impact of Blackboard (Bb) formative assessment on the final score in the endocrine module and determine the medical students’ perception of the impact and effectiveness of Bb. Methods: This exploratory case study was carried out at the King Abdulaziz University (KAU), Jeddah, Saudi Arabia (SA). Blackboard was used in the course management and formative assessment of third-year medical students and three years of data was collected (2016, 2017, 2019). In the last week of the module before the final exam, a formative assessment test that comprised of 50 Multiple Choice Questions (MCQs) was posted on Bb each year. All the students filled a questionnaire regarding their perception about the impact and effectiveness of Bb. Results: Overall, summative exam scores were significantly higher than the scores in formative assessment (p

Objective: To investigate the relationship between serum leptin and reproductive hormones in females with unexplained infertility (UI). Methodology: It was a case-control study conducted in the Gynecology and Obstetrics Department and Infertility Clinic, Jinnah Postgraduate Medical Center (JPMC), Karachi, Pakistan. A total of 235 primary infertile females with an unidentified cause of infertility were selected from the Infertility Clinics. The patients were excluded if they were found to have polycystic ovary syndrome, endometriosis, tubal blockage, irregular menstrual cycles, hyperthyroidism, hypothyroidism, hyperprolactinemia, hyperandrogenemia, fasting blood sugar >110 mg/dl, and male factor infertility. A total of 205 healthy, fertile females were selected from the general population. The blood samples of both groups were collected on the 12th and 21st day of their menstrual cycle. Serum leptin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and E2 levels were measured. Statistical analysis was executed using the SPSS version 16 (SPSS Inc., Chicago, IL). Results: No significant difference was observed in leptin values of fertile and UI females, 37.110±1.19 vs. 35.321±0.901. In the preovulatory phase (12th day) of the cycle, infertile subjects with body mass index (BMI)

BackgroundThis study aimed to estimate stress markers, oxidative stress (OS), reproductive hormones and sperm parameters in male smokers and non-smokers and observe the impact of oxidative stress markers and smoking on sperm count, motility and morphology in a selected population of Karachi, Pakistan.MethodsThis cross-sectional study was conducted from July 2017 to July 2018 at Aga Khan University (AKU), in Karachi, Pakistan. The subjects were recruited from the Sindh Institute of Reproductive Medicine (SIRM), Karachi based on defined inclusion criteria. The subjects were categorized into fertile and infertile based on cut off values of sperm parameters as recommended by the WHO i.e., sperm count/ejaculate of 39 × 106/ml, sperm motility 40% and normal morphology 4%. Two hundred eleven fertile and 165 infertile male subjects were included in the study. Serum cortisol, adrenaline, superoxide dismutase (SOD), and glutathione peroxidase (GPX) were analyzed by ELISA kits. Data was analyzed on SPSS-22. A p-value of

Objective This study aims at a recognition of the differences in the study habits, approach to teaching resources, and spare-time activities of medical students in the preclinical and clinical training periods at King Abdulaziz University (KAU) Jeddah, Saudi Arabia (SA). Methods Study sampling was carried out in 2017 at the Faculty of Medicine, KAU, Jeddah, SA. Students from both genders were included and further subdivided to preclinical (2nd and 3rd years) and clinical groups (4th, 5th, and 6th years). Students were asked to respond to an online questionnaire. SPSS-Version 21 (IBM Corp., Armonk, NY, US) was utilized for statistical analysis of the collected data, Results Of the 347/500 (response rate 69.4%) medical students, 85 (24.5%) were from the preclinical students (2nd and 3rd years), and 262 (64.5%) were enrolled in the clinical group (4th to 6th years of MBBS). The majority of students 330 (94.1%) were unmarried, only 17 of them, i.e., 4.9%, were married. Analysis of the data revealed that medical textbooks, essential versions of basic medical books, online resources, and online version of books were used more frequently by the clinical group as compared to the preclinical students. Teacher-provided lecture handouts and lecture notes taken during classes were being equally used by both groups. There was a significant difference in the opinion on the usefulness of different resources between both groups. Students faced difficulty in understanding the English language, observed more in the pre-clinical years as compared to relatively groomed clinical students. The preclinical group could not understand the teaching material in books due to a weaker understanding of the English language. Social media software was used for keeping both groups busy, but clinical students also used social media for academic purposes. More than half of the participants from the preclinical and almost one-third from the clinical years admitted that their teachers recommended them for relevant medical textbooks. An encouraging trend was observed in most preclinical group students: they found teaching modalities, such as problem-based learning (PBL) and other academic activities, as a trigger to promote book reading. Conclusion Our results show that the students in the clinical phase had a more methodical approach to professional studies and a difference in spare-time activities.

Background The practice of hand hygiene (HH) has prime importance among Health Care Professionals (HCPs) and non-compliance could cause adverse consequences. By keeping the importance of HH in mind, this study aims at investigating the knowledge and attitudes towards HH among medical students and interns at King Abdulaziz University (KAU), Jeddah, Saudi Arabia (SA). Methods The study includes 453 medical students and interns (189 males & 264 females). This study was completed in three months; from September to November 2017. The World Health Organization (WHO) HH questionnaire was used and data were analyzed on SPSS-21. Results Two-third of the participants 292 (64.2%) had formal training in HH in the last three years. Almost half of the participants 254 (56.1%) had correct knowledge regarding the major course of transmission of potentially detrimental microbes among patients in the healthcare premises. Just 124 (27.4%) of the respondents had the correct knowledge about the most common basis of germs accountable for healthcare-related infections. Females had significantly better knowledge than males regarding the type of HH technique needed before palpation of the abdomen (177(54%) Vs. 151(46%); P P P P P P Conclusion The majority of the participants’ knowledge regarding HH was not up to the mark; however, female students had better knowledge compared to male students. The medical students and interns’ knowledge and positive attitude towards HH can play a pivotal role in preventing HCPs associated infections and it would overall decrease the infection-related burden on the hospital and governmental budgets. It is suggested that multi-dimensional plans are required to change this low compliance to a higher rate.

This study intends to explore the predictors of misconceptions, knowledge, attitudes, and practices concerning the COVID-19 pandemic among a sample of the Saudi population and we also assessed their approaches toward its overall impact. This online cross-sectional survey was conducted at the Faculty of Medicine, Rabigh, King Abdulaziz University (KAU) in Jeddah, Saudi Arabia (SA). Participants were approached via social media (SM), and 2006 participants (953 [47.5%] females and 1053 [52.5%] males) were included in this study. SM was the leading source of information for 43.9% of the study participants. Most of the participants had various misconceptions such as “females are more vulnerable to develop this infection, rinsing the nose with saline and sipping water every 15 minutes protects against Coronavirus, flu and pneumonia vaccines protect against this virus.” About one-third of participants (31.7%) had self-reported disturbed social, mental, and psychological wellbeing due to the pandemic. Many participants became more religious during this pandemic. Two-thirds of the study participants (68.1%) had good knowledge scores. Attitudes were highly positive in 93.1%, and practice scores were adequate in 97.7% of the participants. Participants’ educational status was a predictor of high knowledge scores. Male gender and divorced status were predictors of low practice scores, and aged 51–61 years, private-sector jobs, and student status were predictors of high practice scores. Being Saudi was a predictor of a positive attitude, while the male gender and divorced status were predictors of a negative attitude. Higher education was a predictor of good concepts, while the older age and businessmen were predictors of misconceptions. Overall, our study participants had good knowledge, positive attitudes, and good practices, but several myths were also prevalent. Being a PhD and a Saudi national predicted high knowledge scores and positive attitudes, respectively. A higher education level was a predictor of good concepts, and students, private-sector jobs, and aged 51–61 years were predictors of high practice scores. Study participants had good understanding of the effects of this pandemic.

Objective The purpose of the present study was to explore why our medical students are avoiding the study of professional textbooks. We conducted this study from 10th March to 15th May 2017 at the King Abdulaziz University (KAU), Jeddah, to investigate their preferences towards learning resources, their study habits and correlation of academic achievements as a result of these trends. A questionnaire was provided as a web link. The participants of the study included medical students and data was analyzed on SPSS-Version 21. Results A total of 347/500 medical students participated in the study. Among our participants, there were 123 (35.5%) males and 224 (64.6%) were females. Female students’ spent most of their time reading textbooks as compared to males (P-value = 0.001). Males mostly preferred the lecture handouts provided by their teachers. One-third of students admitted that, due to lack of a good grasp of English, they do not readily understand textbooks and consequently 67 (19.3%) students’ showed a lack of interest in textbooks. Majority of the males 103 (84%) spent twice a time (66 vs. 33%) watching television as compared to the females. WhatsApp and Facebook kept both the sexes busy in most of their spare time.

Objective: To assess the effectiveness of concept mapping (CM) on the academic performance of medical students’ in problem-solving as well as in declarative knowledge questions and their perception regarding CM. Methods: The present analytical and questionnaire-based study was carried out at Bahria University Medical and Dental College (BUMDC), Karachi, Pakistan. In this analytical study, students were assessed with problem-solving questions (A-type MCQs), and declarative knowledge questions (short essay questions), and 50% of the questions were from the topics learned by CM. Students also filled a 10-item, 3-point Likert scale questionnaire about their perception regarding the effectiveness of the CM approach, and two open-ended questions were also asked. Results: There was a significant difference in the marks obtained in those problem-solving questions, which were learned by CM as compared to those topics which were taught by the traditional lectures (p

Objective There is a lack of research-oriented physicians in several Arab countries and especially in Gulf region countries. In this context, it is important to explore medical students’ perceptions and motivations towards research. The aim of the present study was to investigate research attitude, practices, and motivations among medical students from GCC countries. Results There were 228 students who participated in this study (male 88, females 140). Thirty-eight percent of the students were participating from Saudi Arabia, 20.6% from the UAE, 17.1% from Oman, 12.7% from Kuwait and 11.4% from Bahrain. Among participants, 43.0% had experience of funded research, and 53.1% had a contribution to research. The confidence of participants in their ability to interpret and to write a research paper was quite high (70.2%). The majority of the students (87.3%) believed that undergraduate students could conduct research and can present at conferences. Improving research skills, attaining research publication, and improvement in patient care were claimed as the top three motives for conducting research. The majority (75.0%) were compelled to research to facilitate their acceptance to a residency program and 63.6% due to compulsion for a research methodology course. Electronic supplementary material The online version of this article (10.1186/s13104-018-3381-y) contains supplementary material, which is available to authorized users.

Objective. This study highlighted the activity of Mutahassaneen Area during Hajj-1427 Hijra (H). Methodology. This Study was a retrospective observational review of those Hajj patients who stayed in the Mutahassaneen Area "a temporary ward opened adjacent to Al-noor Specialist Hospital, Makkah, KSA, for 21 days for transaction of discharged Hajj patients from inpatients and emergency wards to their respective Hajj missions or groups". Subjects’ demography, diagnosis, with dates and timings of admission and discharge was collected. Data was analysed by SPSS version 13. A p-value < 0.05 was considered significant. Results. Study included 619 patients with predominantly males 426 (68.8%). Majority of subjects 373 (60.3%) stayed < 2 hours in area as well as < 2 days in wards 355 (57.4%). Females spent lesser time than males in area (p=0.02). Males stayed longer in wards as well as in area (linear regression p- value=0.005). Circulatory system diseases counted maximum 186 (30%). A difference was found among stay of different diagnostic groups in area (p=0.05) as well as in wards (p

Background/aim: The present study aimed to assess the VAP rate and to identify VAP prevention activities in public sector hospitals situated in the Makkah Region, Saudi Arabia (SA). Materials and methods: In this cross-sectional study, the VAP data from 13 public sector hospitals were collected from January to December 2013 and analyzed using SPSS 16. Results: The overall VAP rate in Makkah Region hospitals was 6.89 cases per 1000 ventilator-days. There was a significant difference in VAP rate among the hospitals of the Makkah Region (P < 0.001). There was no significant difference in the VAP rate among hospitals, which were using only one, two, or all three VAP preventive approaches (P = 0.26) accredited by the Joint Commission International (JCI) and Central Board for Accreditation of Health Care Institution (CBAHI) (P = 0.12), and using the form in intensive care units (ICUs) (P = 0.85). There was a significant difference in the VAP rate among hospitals having different bed capacities (P < 0.001), data regularly collected (P = 0.03), and had a team to supervise the VAP project (P = 0.04). Conclusion: The VAP rate in Makkah Region hospitals is 6.89 cases per 1000 ventilator-days.

To analyse students' perception regarding the use of portfolio-workbook in ethics course.This mixed method study was conducted at the King Abdulaziz University, Jeddah, Saudi Arabia, in 2014, and comprised fourth-year medical students. The "portfolio-workbook", developed on principles of cognitive load and guided learning theories, contained essential reading material. Learning sessions were also facilitated by teaching tools like role-plays, movie/video clips, vignettes, etc., followed by reflective writing exercises. Feedback questionnaire with open- and closed-ended questions was used to collect data. Quantitative data was analysed for frequencies and percentages. Content analysis was conducted for the open-ended responses.Of the 20 participants, 10(50%) considered using portfolio-workbook as difficult initially. However, on completion of module 16(80%) found it easy. Moreover, 17(85%) appreciated it as a learning tool. Besides, 19(95%) students found teaching videos and 13(65%) found open discussions as effective learning tools. Portfolio-workbook as an assessment tool was preferred by 19(95%) students.The use of portfolio-workbook in teaching ethics to undergraduates was found to be encouraging as it generated interest and interaction.

To assess the frequency and its correlation of patient fall with preventing or precipitating factors among inpatients.The observational study was conducted in Makkah Region, Saudi Arabia from October 15 2012 to November 4, 2013. Data was collected using a questionnaire from 16 hospitals in four districts of Makkah province. The material was sampled through systematic randomisation from inpatient files and data was collected for those who had fallen inside the hospital. The questionnaire, validated through a pilot study run under the Directorate of Quality and Patient Safety in Makkah, was used to see whether the hospitals had adopted and applied international standards for assessment of adult and paediatric patients for falls as well as effectiveness of these applications.Of 4,799 beds, occupancy rates ranged from 1680(35%) to 4,799(100%). Out of 291 falls in all, 144(49.48%) were in Jeddah. Besides, 116(40%) of the falls occurred in the last quarter of the Islamic calendar. Statistically significant difference was found in fall episodes in different months (p=0.007). Statistical analysis indicated that the factors that significantly raised the number of patient falls were increase in hospital beds and their occupancy rate (Spearman's correlation: 0.621 and 0.579 respectively).The frequency of falls varied from hospital to hospital and factors like higher number of bed capacity and occupancy rate increased the falls.

Introduction The annual pilgrimage to Mecca (Hajj) is one of the largest gatherings in the world and thus its participants are exposed to various communicable and noncommunicable diseases. This provides an opportunity to study travel epidemiology. Objectives The aim of the study was to estimate the predictors of asthma severity during the Hajj. Patients and methods The study cohort was recruited from patients who presented to the emergency department (ED) of the King Abdul Aziz Hospital, Mecca, Saudi Arabia, between December 3 and 18, 2008 (5-20 Dhul-Hijjah 1429 H). We included newly diagnosed and previously documented cases presenting with asthma symptoms. Sociodemographic and clinical data were collected and the risk factors were assessed. The severity of asthma exacerbation was measured according to the National Heart, Lung, and Blood Institute guidelines. Data were analyzed using the SPSS software. Results The study involved 58 subjects, including 38 women (65.5%). There were 27 subjects (46.6%) with mild asthma attack, 18 (31%) with moderate asthma attack, and no cases with life-threatening asthma. Insignificantly increased risk of severe asthma attack was observed in the following groups: women, people aged 46-60 years, pilgrims (hajis) who did not belong to a hajj group, non-hajis, illiterates, and nonsmokers - the odds ratio (OR) (95% confidence interval [CI]) was 3.7 (0.7-18.5), 1.7 (0.5-6.3), 2.4 (0.7-8.5), 5.1 (0.6-44.1), 2.3 (0.7-9.1), and 2.0 (0.4-10.4), respectively. Forty-six subjects (79.3%) had a history of allergy to components of smoke, detergents, dust, animal dander, and perfumes, while only 5 patients (8.6%) had drug allergy. High risk of severe asthma was observed in subjects with a history of drug allergy, as well as in obese subjects and those who often presented to the ED - OR (95% CI) was 6.5 (0.9-43.9), 18.0 (4.0-80.7), and 3.1 (0.8-11.5), respectively. Conclusions Higher risk of severe asthma attack was observed in women, people aged 46-60 years, hajis who did not belong to a hajj group, non-hajis, illiterates, nonsmokers, obese patients, and those who often presented to the ED within the previous 12 months due to asthma exacerbation.

Objective: This study had been conducted to highlight the pattern of presenting complaints of the patients admitted in internalmedicine wards of a tertiary care hospital. Design: This observational study was conducted in internal medicine wards of Alnoor SpecialistHospital, Makkah, Saudi Arabia, from 31 -08-2004 to 14-10-2004. Methodology: The data had been collected retrospectively from the files andconsisted of demography, wards allocations, duration of stay, and frequency as well as duration of symptoms at the time of presentation. Datawas analyzed by SPSS version 16 and p6 types of complaints. Diseases of the circulatory system were more prominent (16.5%). Morethan two third patients improved (75.7%) while 9.7% died. Conclusion: Maximum patients were within 65 to 74yrs of age. Saudis were olderand stayed longer than non-Saudis. Fever was the commonest presenting complaint. Minimum patients presented with >6 complaints anddiseases of the circulatory system predominated. A few died but most of them improved.

To evaluate students' perception about the educational environment at two medical colleges.The cross-sectional study was conducted at King Abdulaziz University, Rabigh and Jeddah campuses, in Saudi Arabia, during the first semester of the year 2014 using Dundee Ready Education Environment Measure inventory. Data was collected from undergraduate medical students and analysed using SPSS 16.Of the 279 subjects in the study, 141(50.5%) belonged to the Rabigh campus, and 138(49.5%) to the Jeddah campus. Overall mean Dundee Ready Education Environment Measure inventory score was 124.90±20.66. The score for Jeddah was 131.38±21.37 and for Rabigh it was 118.56±17.85 (p=0.0001). The difference was also statistically significant in all domains of the inventory (p0.05 each).Students' perception of their educational environment was positive in both campuses, it was more positive in Jeddah compared to Rabigh.

The enzyme glutathione S-transferase Mu 1 (GSTM1) is encoded by the GSTM1 gene. Polymorphisms in GSTM1 affect the detoxifying function of the enzyme variants. This forms the basis of the debate about the impact of the GSTM1 null/present genotype on colorectal carcinoma risk. We tested the potential influence of GSTM1 polymorphisms on the development of colorectal cancer. DNA extracted from 83 samples taken from patients that were previously diagnosed as having colorectal carcinoma and from 35 control subjects who did not have colorectal carcinoma were amplified. GSTM1 genotypes were determined by DNA sequencing. The current study revealed that the majority (69/83, 83%) of colorectal cancer cases harbored the null genotype (GSTM1*0/*0), and the remaining 14 (17%) cases harbored either the GSTM1wt/wt or the GSTM1wt/*0 genotype. In contrast, among the control cases, 23 (65%) had the null genotype (GSTM1*0/*0) and 12 (35%) had either the GSTM1wt/wt or the GSTM1wt/*0 genotype. The current report emphasizes the impact of the GSTM1 null genotype on the increased risk of colorectal carcinoma in Saudi Arabia.

BACKGROUND AND OBJECTIVE: Every year 2-3 million Muslims gather for a few days around the Holy city of Makkah in Saudi Arabia to perform Hajj. Managing enormous health issues associated with such a mass gathering requires a very vibrant health delivery plan. Related research is part of the strategy. This study was done to assess the pattern of patients and illnesses encountered at one health facility at Arafat on the 2nd day of Hajj, when all the pilgrims move from Mina and stay in Arafat for a few hours. The objective of the study was to provide input so that recommendations can be given for future improvement of health care during this mass transit. METHODS: All patients reporting sick to the Nimra Hospital on the Day of Arafat were included and documented on a detailed Performa and analyzed. RESULTS: We received 211 patients, essentially all of those were in need of acute medical intervention. Acute severe asthma and injuries were the major problems encountered. There were two deaths both related to heat stroke. Patients received were predominantly Arabic speaking. CONCLUSIONS: Only those needing acute intervention seek medical advice during transit. Well equipped and staffed health facilities are, however, needed to cater these and for any mass casualties. Pre Hajj training and mandatory Flu vaccination can help. Language: en

Objective: To identify the frequency and reasons of operations cancellation in 25 Makkah region hospitals in Saudi Arabia. Methods: Retrospective evaluation of the rate of surgery cancellation in 25 hospitals of Makkah region was performed in this study. The data of scheduled surgeries from 15 different surgical specialties was collected from January to December 2013. Frequency and reasons of cancellation of elective surgical cases in different specialty were studied with a view to recommend suggestions for improvement. Data was analyzed on SPSS -16. Results: There are 120 operating rooms (OR) in 25 Makkah region hospitals and during the year 2013, a total of 16,211 surgery cases were listed, and 1,238 (7.6%) cases were canceled. Contribution to total cancellation was highest in orthopedic 33.8% followed by general surgery 27.5%, obstetrics 7.7% and ENT 5.2%. According to category, 42.81% rate of cancellation was patient related, 20.03% facility related, 9.45% due to improper work-up, 1.45% associated with anesthesia, 7.19% related to surgeons, and 18.90% other/ and not recorded reasons. Conclusions: Present study found 7.6% cancelation rate in Makkah region hospitals and three most common causes for cancellations were patients related, facility related and improper work-up.

Glutathione S-transferase pi (GSTP1) is a candidate enzyme that may be involved in colorectal cancer susceptibility. Polymorphism of GSTP1 gene may cause changes in expression or structure which lead to alteration in the efficiency of catalytic function of the enzyme variants, i.e., deficient detoxification of carcinogens and consequently influences coloreActal cancer development. The present report examined the possible impact of GSTP1 (Ilel05Val) polymorphism and the risk of colorectal cancer.Samples of paraffin embedded tissues from 83 patients with colorectal cancer as well as thirty five non-cancerous colon tissues were collected from the archive of the pathology department at King Abdulaziz University in Saudi Arabia. All cancer and control samples were subjects to DNA extraction then amplification. DNA genetic analyzer from Applied Biosystems was used to sequence the product of amplification for genotypes determination.None of the genotypes of GSTP1 was associated with the risk of colorectal cancer development. There were no statistical differences in the frequencies of GSTP1 genotypes between colorectal cancer cases and controls.The incidence of (Val/Val) genotype in colorectal cancer cases was three folds higher than controls. This finding is not statistically significant, but it could be of clinical consequence that it may increase the risk of colorectal cancer in Saudi Arabia.

Background: This study aimed to highlight the health seeking behavior of children in an Emergency Department (ED). Materials and Methods: Retrospective files review of ED was done for the month of July, 2008. Data about the children ≤12 years of age was gathered. Results: In one month period a total 21000 patients visited our ED, out of them 6120 (29%) were children. Males, Saudis and children of (1‑6 years) were more frequent, i.e., 3540 (57.8%), 5760 (94.1%) and 3180 (52%), respectively. Majority of patients visited in shift “2”, i.e., 15:30 hours to 23:30 hours. Among the patients “diseases of respiratory system” were found more frequent 4170 (68.1%) and main diagnosis was “acute upper respiratory tract infection” 3300 (53.9%). Non‑urgent cases were 2020 (33%) while 244 (4%) were admitted. Conclusion: Young children as well as non‑urgent cases were predominant. Evening shift was the busiest one.Keywords: Children, emergency, infection, respiratory tractNigerian Medical Journal | Vol. 53 | Issue 3 | July-September | 2012

OBJECTIVES To determine the prevalence of intestinal parasites among patients of a tertiary care hospital. METHODS A total of 12,054 samples received from the outpatient as well as inpatient departments from January 1, 2004 to December 31, 2009 in Al-Noor Specialist Hospital, Makkah, Saudi Arabia. Stool examinations were performed by direct method and concentrated Techniques for all patients. RESULTS Overall, the prevalence of intestinal parasites was 6.2% (740 cases). Majority of patients were infected by Entamoeba histolytica (4.7%) followed by Giardia lamblia (1.3%), while Ankylostoma duodenal (0.02%) exhibited the minimum prevalence. Parasitic infections were more frequent in non-Saudis than Saudis patients (7.1% vs. 5.8%; p

The incidence of patients with end-stage renal failure and type 2 diabetes mellitus as a comorbid condition has increased progressively in the past decades. Causes of renal disease might vary from one population to another. The aim of this study was to know the characteristics of the diabetic patients on regular dialysis at Al-noor Specialist Hospital, Makkah, SaudiArabia. The data had been collected retrospectively in the month of Shawal 1425 corresponding to 13-11-2004----12-12-2004 from the diabetic patients directly that were on dialysis due to end stage renal disease (ESRD) and from their files. The mean age of Diabetics was (55.2years) showing male predominance 31(60.8%). All were Saudies. The mean duration of Diabetes mellitus & dialysis were (16.8years) and (22months), respectively. The mean age of start of Diabetes mellitus & dialysis was (37.4 years) & (53.5 years). The mean duration of onset of diabetes to dialysis was (16.1 years). Out of the total, 29(56.9%) were non-smoker. Patients with family H/O diabetes with other associated illnesses were 23(45%) followed by 15(29.4%) had family H/O only diabetes. Type II diabetics were 40(78.4%). Regarding metabolic profile, patients with high blood glucose level were 10(19.6%) while 3(5.9%), 50(98%) & 18(35.3%) patients had high cholesterol, low density lipoprotein & triglyceride levels, respectively. Maximum patients were in sixth decade of life. Up to three fourth patients had family H/O diabetes. Most of the subjects had only diabetic nephropathy. Maximum patients had high low density lipoprotein level. Dialysis was main treatment to control diabetes. Key words: Diabetes mellitus, dialysis, ESRD, diabetic nephropathy

This study highlighted the reasons which contributed to longer stay of patients in Emergency Department (ED) who were advised admission.This study was conducted from August 4 to 11, 2004G as a retrospective review of the ED cards of patients admitted to inpatients wards of Al-Noor Specialist Hospital, Makkah, Saudi Arabia. The demographic data, doctorsnurses notes with their timings were reviewed. The maximum consumed time by a reason was considered as the main reason of delay for that subject. The delayed patients were divided into Group A and B, delayed before and after admission was advised, respectively. Prolonged length of stay (Delay) in ED was defined as stay longer than 2 hours after patient's arrival in ED until they were received to wards.Out of total 4876 visits during study period, 355 (7.3%) patients were admitted, and 238 (67%) were delayed. Age group 13-30 years was common in delayed 78 (32.8%) and not delayed 56 (47.9%) subjects. The mean length of stay of delayed subjects was 256 minutes. Group A 146 (61.4%) had more subjects than group B 92 (38.6%) (p0.001). Fifty eight (39.7%) patients stayed between 2-3hours in Group A vs. B 23 (25%) (OR 2, 95% CI 1.1-3.5). Common reason of delay in Group A was multiple consultations with further investigations 70 (48%) (p0.001) while file making process was common 40 (43.5%) in group B (p0.001).Out of admitted patients 67% were delayed mainly due to late advised admission with major reason of delay were multiple consultations.