Video-Based Simulation Among Saudi Undergraduate Nursing Students During COVID-19: A Qualitative Study.

Background Because of university closures due to COVID-19 confinement, video-based simulation, a training technique based on high-fidelity simulations, was introduced in reaction to the need to adapt high-fidelity clinical simulation experiences to digital platforms. Purpose This study aims to evaluate the perceptions of nursing students in Saudi Arabia regarding the shift from face-to-face simulation experiences to video-based simulation during the COVID-19 pandemic. Methods This study employed a phenomenological exploratory qualitative research design among 32 nursing students from various academic levels. Results The thematic analysis gave rise to five themes namely, "Enhanced Learning and satisfaction", "Improved communication skills", "Lack of hands-on experience", "More comfortable experience", and "Technical Barriers". Conclusion The students in this study have indicated that they were satisfied with video-based simulation, where they reported enhanced learning, better communication skills, and more perceived comfort, while concerns regarding technical issues and nursing skills were raised.

Hepatitis C virus genotypes in a cohort of Middle Eastern patients.

BACKGROUND: The epidemiology of hepatitis C virus infection has been well characterized in Western Europe, North America and Japan. Less is known about it in other regions of the world. In order to fully understand the relationship between host and virus, it is important to study the effect of virus infection in all regions of the world. In this report, we have analyzed patients from the United Arab Emirates, Egypt and Jordan. DESIGN AND METHODS: Serum from 81 Middle Eastern HCV ELISA-2-positive patients was analyzed for the presence of HCV RNA by PCR. RNA-positive patients were genotyped by selective hybridization of amplicons to HCV genotype-specific oligonucleotides (InnoLipa2, Innogenetics, Belgium). Where possible, data was also obtained on racial origin, liver histology, serum ALT, prothrombin time, albumin, and risk factors for infection. RESULTS: Sixty-five of 81 patients were HCV RNA-positive. A higher proportion of Middle Eastern patients were genotype 4 compared to equivalent studies from Western Europe, USA and Japan. However, the most common genotype was 1a. No significant difference in genotype was found between patients with chronic hepatitis and patients with cirrhosis. CONCLUSIONS: Eight of 65 (12%) patients were genotype 4, but the most common genotype was 1a, a âWesternâ genotype (24/65, 37%). The mean age of cirrhotics was low compared to Western studies. This may be due to infection in early childhood or race-related host factors. Twelve of 65 patients (18%) were not classifiable for genotype using InnoLipa2. This may be due to multiple infecting genotypes in these patients, or unusual, non 13 HCV genotypes which cannot be classified by InnoLipa2.

Chronic splenomegaly in Nairobi, Kenya. II. Portal hypertension.

Eighty-five patients with chronic splenomegaly and proven oesophageal varices were studied at Kenyatta National Hospital, Nairobi. The major defined groups were hepatosplenic schistosomiasis (24%), cirrhosis (20%) and portal vein occlusion (11%). Hyper-reactive malarial splenomegaly (tropical splenomegaly syndrome) was considered as the cause of oesophageal varices in only one patient. In 26% of cases liver biopsy was non-diagnostic and the extrahepatic portal vein was demonstrated radiologically to be patent. Such patients were thought to be suffering from idiopathic portal hypertension, not previously described elsewhere in Africa. Hepatitis B surface antigen was detected in 12% of controls and in 58% of patients with cirrhosis (p less than 0.001). Some serological marker of previous hepatitis B virus infection was present in 92% of patients with cirrhosis and in 79% of controls. Kamba patients from Machakos and Kitui Districts were significantly more prevalent than expected among these 85 cases of portal hypertension.

Portal hypertension in Nairobi, Kenya.

Previous reports have suggested that idiopathic portal hypertension, a condition quite distinct from tropical splenomegaly syndrome, occurs in Kenya. In the present study patients with oesophageal varices were allocated to diagnostic groups on the basis of liver histology and results of splenoportovenography , and these groups were then compared for prevalence of hepatitis B markers, immunoglobulin levels and results of enzyme-linked immunosorbant assay (ELISA) for S. mansoni infection. 85 patients with oesophageal varices were studied. 29.4% had histological evidence of Schistosoma mansoni infection, 20% had cirrhosis and in 25.9% liver histology was non-diagnostic and the portal vein was radiologically shown to be patent. A comparison of clinical findings, serological data and parasitological investigations suggested that this latter group was a distinct one, and did no result from failure of histological diagnosis of cirrhosis or schistosomiasis. It is likely that these patients had idiopathic portal hypertension. In 82 normal controls, the carrier rate of hepatitis B surface antigen (HBsAg) was 12.2%, 59.8% had antibody to HBsAg (anti-HBs) and 7.3% showed antibody to core antigen (anti-HBc) as the only viral marker. 58.3% of the cirrhotics and 26.7% of patients with probable idiopathic portal hypertension were HbsAg positive. The implications of these results, and limited data on hepatitis Be antigen and antibody are discussed.

Esophageal varices in Nairobi, Kenya: a study of 68 cases.

Sixty-eight patients with proven esophageal varices wer studied at Kenyatta National Hospital, Nairobi, Kenya. Of these patients, 29.4% had schistosomal portal hypertension, 22.1% cirrhosis and only 8.8% extrahepatic portal vein occlusion. One quarter of the patients had a normal liver biopsy and extrahepatic portal vein that was demonstrated to be patent. Problems relating to liver biopsy sampling resulting in underdiagnosis of specific causes of esophageal varices such as schistosomiasis are discussed. We argue that many of these patients were likely to be suffering from idiopathic portal hypertension, a condition apparently not previously recognized in Africa. Of this last group, 70.6% had suffered gastrointestinal bleeding, as had 50% of the patients with schistosomiasis. Together these two groups accounted for three-quarters of all patients who had bled. The detection of eggs of Schistosoma mansoni in stool and/or rectal snip correlated well with liver biopsy findings in both a positive and negative sense. Only 18% of patients with negative stools and snips had evidence of schistosomiasis in the liver, and positive stools or snips were found in only 14.6% of patients without schistosomal liver involvement. Of the patients in the study, 50% were of the Kamba tribe, although only 12.9% of all medical admissions to the hospital were Kamba (P less than 0.01). Luo patients were significantly more frequent within the group with schistosomiasis (P less than 0.02). Esophageal varices were attributed to tropical splenomegaly syndrome in only one patient. The implications of our results are discussed and our findings are compared with previous work from East Africa.