Factors Influencing Specialty and Training Center Choices Among Saudi Medical Residents.

AIM: This cross-sectional study aims to identify and quantify the factors influencing Saudi medical residents in selecting their desired specialty and primary training center, while examining the associations between these factors. METHODS: The study received approval from an institutional ethical committee at King Abdulaziz University. An electronic questionnaire was designed and validated via content, face validity, and the Content Validity Index. The sample size was calculated based on a 95% CI and a 5% margin of error. The study targeted all current residents in the current Saudi Specialty Certificate Programs. Descriptive statistics summarized demographic characteristics, training-related information, and factors influencing the selection of a specialty and training center. Fisher's exact test and Chi-square tests were employed for data analysis. RESULTS: A total of 387 respondents completed the survey, with a 32.3% response rate. The majority of respondents were male (n = 232, 59.9%), and the majority were also married (n = 67.2%), with internal medicine (n = 92, 23.8%) and family medicine (n = 74, 19.1%) being the most prevalent specialties. Notably, 89.4% (n = 346) reported matching into their first-choice specialty, and 67.2% (n = 260) into their first-choice training center. Furthermore, 90.2% (n = 349) had prior training (elective/internship) in their chosen specialty, and 63% (n = 244) had previous training (elective/internship) at their primary training center. Prior exposure to both specialty and center significantly resulted in them being the resident's top choice (p < 0.01). Multiple factors influencing the choice of either the specialty or the center were found to have statistically significant associations with the gender, specialty, residency level, sector of the training center, and timing of the specialty decision (p < 0.05). CONCLUSION: This study reveals the substantial influence of early experiences on Saudi medical residents' specialty and training center choices. It also uncovers gender disparities and variations in the influence of specialty-related factors. Future research with larger and more diverse samples is recommended to gain a deeper understanding of the multifactorial decision-making processes, enabling the development of strategies to better meet the evolving needs and preferences of healthcare professionals in Saudi Arabia.

Effect of Hemodiafiltration Versus Hemodialysis on Cognitive Function Among Patients With End-Stage Renal Disease: A Multicenter Study.

BACKGROUND: Cognitive impairment (CI) and dementia are common in patients with end-stage renal disease (ESRD) undergoing hemodialysis. Their cause is multifactorial. Our study is first to compare the impact of hemodialysis (HD) and online hemodiafiltration (HDF) on patients' cognitive outcomes. METHODS: This was a cross sectional, multicenter cohort study. Adult ESRD patients aged >18 years on regular high flux HD or online HDF were recruited in the study. Clinical, laboratory, daily activities and cognitive functions assessment were assessed in all the involved individuals. RESULTS: A total of 241 patients were successfully recruited into the study: 164 treated with high flux HD and 77 treated with HDF. Hypertension and diabetes were the commonest associated comorbidities. 85.9% of patients were functionally independent with no significant difference between those on HD versus HDF. 81.3% of our patients showed different degrees of CI. HDF has no superiority in the improvement of cognitive functions. Age, vitamin D level and haemoglobin (Hb) were the most independent predictors of cognitive function impairment among HD patients. CONCLUSIONS: Cognitive function impairment is a common problem in hemodialysis and is associated with multiple risk factors. HDF showed no beneficial effect over HD. There is no superiority of online HDF versus high flux HD in improving cognitive functions.

Prevalence of migraine among the general population, and its effect on the quality of life in Jeddah, Saudi Arabia.

OBJECTIVES: To estimate the prevalence of migraine headaches, assess the quality of life (QoL) of migraine patients, and compare the QoL between migraine patients and the general population in Jeddah, Kingdom of Saudi Arabia. METHODS: A descriptive cross-sectional study was carried out in 2021 on 2058 adults who agreed to participate in the study and completed a questionnaire. The ID-migraine scale was used to screen for migraine, and participants were divided into 3 groups (normal, non-migraine headaches, and migraine headache). To assess and compare the QoL between the migraine group and the normal population, the 36-item short- form survey was used. RESULTS: The prevalence of migraine headaches was 37.2%, with a higher prevalence among females (81.1%), and the highest prevalence was observed among students (43.3%). The most common manifestation associated with migraine headaches was photophobia (94.6%), and the most frequently reported triggers were sleep deprivation, stress, and anxiety. In our analysis of the association between migraine headaches and patient QoL, migraine patients showed lower scores in all 8 domains of QoL in comparison with the normal group. Role limitation due to physical health was the most affected domain. CONCLUSION: The current study showed a high prevalence of migraine in Jeddah. Insufficient sleep was the most frequently reported trigger. Migraine significantly affects all aspects of QoL in comparison with the normal population.