Perceptions and attitudes of different healthcare professionals and students toward interprofessional education in Saudi Arabia: a cross-sectional survey.

Interprofessional education (IPE) is now regarded as an extremely important approach in the academic field for preparing healthcare students to provide patient care in a collaborative team environment. In this study, we examine the perceptions and attitudes toward IPE in a Saudi specialized health sciences university. This study is a cross-sectional survey at King Saud bin Abdulaziz University for Health Sciences and King Abdulaziz Medical City in Jeddah, Saudi Arabia. The instruments used in this study were pre-designed self-administered questionnaires identified from the literature (The Nebraska Interprofessional Education Attitudes Scale (NIPEAS) and The Student Perceptions of Interprofessional Clinical Education-Revised (SPICE-R). A total of 668 individuals participated in the study. The majority of the participants were between the ages of 18 and 25 (79.2%) and were students (77.1%) from medicine, nursing and applied medical science. The participants' responses were primarily positive for all items of the NIPEAS and most of the items of the SPICE-R. The results of this study indicate that students and healthcare professionals have positive perceptions and readiness toward IPE, and implementation of shared learning is highly encouraged. The integration of IPE in the curriculum is recommended to improve teamwork and patient care outcomes.

Breast MRI Does Not Help Differentiating Radial Scar With and Without Associated Atypia or Malignancy.

PURPOSE: To review breast magnetic resonance imaging (MRI) features of radial scar (RS) with and without associated atypia/malignancy. METHODS: Twenty-eight (mean age 56.8) patients diagnosed with 30 biopsy-proven RS (n = 25, ultrasound-guided 14-gauge, n = 5, stereotactically guided 9-gauge) subsequently underwent breast MRI followed by surgery. Magnetic resonance imaging protocol included axial T1, axial fat sat T2, and postgadolinium in axial and sagittal planes. Two radiologists reviewed the mammographic and MRI findings in consensus according to the Breast Imaging Reporting and Data System lexicon. RESULTS: Of the 30 RSs excised surgically, 14 (14/30, 47.7%) were not associated with atypia/malignancy while atypia/malignancy was found in 16 (16/30, 53.3%) RSs. Three (3/30, 10%) RS lesions did not enhance on dynamic MR. Mean lesion size on MRI was 1.4 cm (range, 0.5-5 cm). Seventeen (17/30, 56.7%) lesions presented as nonmass enhancement and 9 (9/30, 30%) as masses. Nonmass lesions showed focal distribution (13/17, 76.5%) and heterogeneous enhancement (15/17, 88.2%). Masses showed irregular shape and margins (6/9, 67%) and heterogeneous enhancement (8/9, 89%). Multivariate analysis did not show any significant difference in MRI presentation between RS only and RS associated with atypia/malignancy. CONCLUSION: Breast MRI does not help differentiate between RS with or without associated atypia/malignancy.

Identifying Carrier Behavior in Ultrathin Indirect-Bandgap CsPbX3 Nanocrystal Films for Use in UV/Visible-Blind High-Energy Detectors.

High-energy radiation detectors such as X-ray detectors with low light photoresponse characteristics are used for several applications including, space, medical, and military devices. Here, an indirect bandgap inorganic perovskite-based X-ray detector is reported. The indirect bandgap nature of perovskite materials is revealed through optical characterizations, time-resolved photoluminescence (TRPL), and theoretical simulations, demonstrating that the differences in temperature-dependent carrier lifetime related to CsPbX3 (X = Br, I) perovskite composition are due to the changes in the bandgap structure. TRPL, theoretical analyses, and X-ray radiation measurements reveal that the high response of the UV/visible-blind yellow-phase CsPbI3 under high-energy X-ray exposure is attributed to the nature of the indirect bandgap structure of CsPbX3 . The yellow-phase CsPbI3 -based X-ray detector achieves a relatively high sensitivity of 83.6 µCGyair-1 cm-2 (under 1.7 mGyair s-1 at an electron field of 0.17 V µm-1 used for medical diagnostics) although the active layer is based solely on an ultrathin (≈6.6 µm) CsPbI3 nanocrystal film, exceeding the values obtained for commercial X-ray detectors, and further confirming good material quality. This CsPbX3 X-ray detector is sufficient for cost-effective device miniaturization based on a simple design.

Unusual Male Breast Lesions.

Most of male breast masses are benign with gynecomastia being the most common entity encountered. Primary male breast cancer accounts for less than 1% of the total number of breast cancer. Male breast can be affected by a variety of conditions affecting the female breast with less frequency due to the lack of hormonal influence and consequent glandular sub-development. Imaging features of male breast masses are quite similar to the female breast. Therefore, using the knowledge of the female breast and applying it may help in the diagnosis and management of male breast abnormalities. In this article, we aim to review a variety of unusual male breast masses. We discuss the demographics of male breast tumors, describe the diagnostic algorithm for evaluating male breast masses, and review the imaging features of rare breast masses and mimickers of male breast cancer.

Effectiveness and Needs Assessment of Faculty Development Programme for Medical Education: Experience from Saudi Arabia.

OBJECTIVES: Faculty members are the most important resource in any institution of higher education as medical education has been, and continues to be, a priority for medical colleges in Saudi Arabia. This study aimed to assess faculty members' perceptions of faculty development programmes (FDPs) in supporting important goals in medical education. In addition, this study aimed to assess faculty members' perceived needs. METHODS: This cross-sectional study was conducted between August 2016 and August 2017 and involved participants from six universities in Saudi Arabia's Western Province. The survey consisted of 31 items designed to assess FDP effectiveness and 49 items designed to assess needs in FDPs. RESULTS: A total of 210 faculty members participated in the study (response rate = 52.5%) and identified 49 needs. Faculty members perceived personal improvement in delivering medical education and the provision of greater educational involvement as the most effective considerations in an FDP. The respondents considered 13 needs to be of utmost importance; the remaining were considered important. CONCLUSION: This study assessed and identified faculty needs and important skills to consider when establishing an FDP. Furthermore, it provided information addressing the needs of, or gaps between, current and desired conditions in medical education in Saudi Arabia. The study also identified the most important elements (i.e. personal improvement) of faculty-perceived effectiveness for a successful FDP in medical education.

Carotid Artery Angioplasty and Stenting for Carotid Stenosis: A Single-Center Experience from Saudi Arabia.

PURPOSE: Atherosclerotic stenosis of the extracranial carotid artery accounts for approximately 20% of all strokes. Both carotid artery endarterectomy and carotid artery angioplasty with stenting (CAAS) are recommended for symptomatic patients with 50% or more stenosis or asymptomatic patients with 70% or more stenosis. CAAS is under-reported in Saudi Arabia, as evidenced by a thorough literature search. In this article, we aim to share our experience of CAAS to call for the necessity of conducting more research on stroke and emphasize the local need of utilizing more endovascular treatments like CAAS. MATERIALS AND METHODS: A retrospective single-center observational study was conducted at King Abdulaziz Medical City in Jeddah, Saudi Arabia. The inclusion criteria consisted of all adult patients (18 years and above) with carotid stenosis who were treated with CAAS. RESULTS: A total of 16 patients were included in the study. The mean age of the participants was 66.9±13.5 years (range 30-87 years). All patients were symptomatic (had a previous stroke or transient ischemic attack). The procedure was successful in 14 patients (87.5%), while it failed in 2 patients (12.5%) due to technical reasons. All patients had no stroke or myocardial infarction within 30 days of the procedure. CONCLUSION: Despite the advancement in medicine with free healthcare services in Saudi Arabia, the interventional procedures for secondary prevention of strokes are underutilized. Collaboration between different hospitals will be extremely helpful since few centers in each city are providing such treatments by an expert neurointerventionist and/or strokologist. The good selection of candidates, optimal management of comorbid conditions, and multidisciplinary care may improve outcomes and reduce mortality.

Awareness, Self-Use, Perceptions, Beliefs, and Attitudes toward Complementary and Alternative Medicines (CAM) among Health Professional Students in King Saud bin Abdulaziz University for Health Sciences Jeddah, Saudi Arabia.

BACKGROUND: Around 75% of the world's population relies on the use of complementary and alternative medicines (CAM) for their healthcare. Thus, we aimed at assessing the attitude and perception of health professional students about CAM and correlate the results with their demographical data. METHODS: An observational cross-sectional study was conducted at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Jeddah, Saudi Arabia, by enrolling 350 students. A self-administered questionnaire was used for data collection. Descriptive and inferential statistical analysis was performed using SPSS. RESULTS: Results of our data suggested that majority of students were aware of the CAM modalities and considered prayers/spirituality (83.6%), massage (72.5%), nutritional supplements (74.1%), cupping (68.5%), herbal medicine (66.2), and yoga (61.6%) as most effective and least harmful CAM modalities. The students acquired more information about CAM from media (55%), books (56%), friends/relatives (59.7%), and other health professionals (58.4%), however, very little information from formal CAM courses or training (36.7%), which shows the lack of courses and trained health professional in the field of CAM. Despite utilizing nonreliable sources of CAM information, the majority of students had positive attitudes and perceptions about CAM usage. Majority of the students (75.8%) believe in the use of CAM for the mental and spiritual aspect of health and think that CAM providers give good information on maintaining a healthy lifestyle. The data also showed a significant (P < 0.05) association between awareness about CAM and gender. A significantly higher percentage of female students were using yoga and aromatherapy, while cupping was mostly used by male students. Similarly, a significant association was found among the different colleges and level of students in most of the CAM modalities. However, no association was found between the awareness and use of CAM with the educational level of parents or relatives in health sector except for acupuncture and cupping, where student's awareness about acupuncture and cupping was found to have a significant positive association with mother educational level. On the other hand, a significant inverse association was found between acupuncture, yoga, cupping, and aromatherapy with family income. CONCLUSION: In conclusion, despite the lack of proper courses and professionally trained healthcare providers in the field of CAM, students demonstrated positive attitudes and beliefs toward the safety and effectiveness of CAM.

Clinicoradiological Discrepancy in Multisystem Langerhans Cell Histiocytosis with Central Nervous System Involvement.

Langerhans cell histiocytosis (LCH) is a rare neoplasm that is caused by an uncontrolled proliferation of Langerhans cells. The clinical presentation of LCH is heterogeneous and can manifest as single or multiple osteolytic lesions, skin ulcerations, and involvement of single or multiple systems. Central nervous system (CNS) involvement is reported in 3.4-57% of patients with multisystem disease. In this article, we present the case of a young man with single system involvement (bone) of LCH who presented with seizures, headache, papilledema, and tinnitus. His magnetic resonance imaging (MRI) of the brain findings were reported as a normal study. The subtle signs of CNS involvement were missed by the radiologist. However, the high index of suspicion resulted in early diagnosis and treatment. The presence of empty sella turcica in neuroimaging could be the first sign of intracranial disease with chronic intracranial hypertension associated with LCH. This is especially correct if previous computed tomography (CT) scan of the brain was normal with normal appearance of the pituitary gland and the sella. Neuroimaging films should be reviewed by an expert neuroradiologist. In patients with new neurological symptoms who were diagnosed previously with LCH, intracranial disease has to be excluded. The workup in such case should include an MRI of the brain, CT of the brain and temporal bones, bone scan, cerebrospinal fluid analysis, ophthalmological assessment, and measurement of intracranial pressure. In patients with LCH who present with symptoms and signs of raised intracranial pressure, the term idiopathic intracranial hypertension should not be applied until an intracranial disease has been excluded totally. Keywords: Langerhans Cell Histiocytosis; Central Nervous System Involvement; Neuroimaging; Intracranial Hypertension.

Learning styles and satisfaction with educational activities of Saudi Health Science University Students.

OBJECTIVES: Medical knowledge is constantly changing; this puts pressure on educators to adapt instructional strategies to their students' learning styles (LSs). Therefore, identifying the LSs of medical students could help teachers to develop teaching strategies to achieve better outcomes. The purpose of this study was to determine the LSs of health science university students, and to assess the relationship between LSs and student satisfaction with educational activities. METHODS: This cross-sectional descriptive study was conducted in the Colleges of Medicine and Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) Jeddah. We used Kolb's LS and a modified Student Satisfaction Survey from Mott Community College, Michigan. All participants received self-administered questionnaires; LS and demographic data were used as predictor variables. Students' satisfaction levels were considered the outcome variable. RESULTS: A total of 359 students were recruited (mean age 19.0 ± 1.4 years; 53.5% males). The most popular LS was Accommodator (29.2%), followed by Assimilator (27.9%) and Diverger (25.6%), while the Converger style (17.3%) was the least preferred LS. The satisfaction scores of the students showed that they were generally satisfied with a mean score of 64.4%. Males were found to have higher satisfaction across all variables than females (p = 0.002). CONCLUSIONS: This study could not find a predominant LS or satisfaction difference across LSs among health science students. Thus, the current educational programmes in KSAU-HS meet students' LSs and satisfaction. Educators need to broaden their strategies for instruction, so as to build an effective learning environment.

Nosocomial herpes simplex encephalitis: A challenging diagnosis.

Herpes simplex encephalitis (HSE) is a rare disease, but it is the most common form of sporadic encephalitis. HSE is transmitted through direct contact and developing nosocomial HSE is rarely reported in the literature. Nosocomial HSE is difficult to diagnose due to its non-specific clinical features. In this article, we present a case of nosocomial HSE that was responsible for grave consequence. We also explore its causes, outcome, and give recommendations to avoid such fatal occurrence. We stress on strict adherence to the standard precautions and preventive control measures.

Neurological Complications of Middle East Respiratory Syndrome Coronavirus: A Report of Two Cases and Review of the Literature.

Middle East Respiratory Syndrome Coronavirus (MERS-CoV) was first discovered in September 2012 in Saudi Arabia. Since then, it caused more than 1600 laboratory-confirmed cases and more than 580 deaths among them. The clinical course of the disease ranges from asymptomatic infection to severe lower respiratory tract illness with multiorgan involvement and death. The disease can cause pulmonary, renal, hematological, and gastrointestinal complications. In this paper, we report neurological complications of MERS-CoV in two adult patients, and we hypothesize the pathophysiology. The first patient had an intracerebral hemorrhage as a result of thrombocytopenia, disseminated intravascular coagulation, and platelet dysfunction. The second case was a case of critical illness polyneuropathy complicating a long ICU stay. In these cases, the neurological complications were secondary to systemic complications and long ICU stay. Autopsy studies are needed to further understand the pathological mechanism.