Symptomatic arteriovenous malformation of the thyroid/parathyroid gland: A case report.

Arteriovenous malformations (AVMs) are complex vascular lesions most commonly found in the brain and infrequently found in the head and neck. AVMs are characterized by a tangle of blood vessels called a nidus, which shunts blood from an artery directly to a draining vein. Various treatments are available, including surgical resection and endovascular embolization. Here, we report the case of a 32-year-old male patient who complained of painful pulsating left neck swelling with dysphagia for 1 year, which turned out to be an AVM alongside the left thyroid gland. The AVM was treated by embolization using Onyx in 2 sessions. The patient has been free of symptoms since the treatment.

Awareness and Attitudes Toward Childhood Mental Disorders Among Primary School Teachers in Taif, Saudi Arabia.

Background and aim Early detection and intervention can improve the treatment outcome of childhood mental disorders, and primary school teachers may play an important role in referring suspected cases to mental health facilities if they have good awareness and attitudes toward these disorders. The aim of this study is to assess the awareness and attitudes of primary school teachers toward childhood mental disorders in Taif, Saudi Arabia. Methods This is a cross-sectional study conducted among classroom teachers in primary schools in Taif, Kingdom of Saudi Arabia. It was conducted during the period from 2022 to 2023 in both public and private schools. An anonymous, self-administered, online questionnaire was used to assess participants' awareness and attitudes toward pupils with mental health issues. The collected data were analyzed using the chi-square test to examine the associations between various categories and the ANOVA test to compare means. Results The study included 417 teachers, 63.5% of whom were males, the mean of their ages was 39.59 years (SD±8.66), and the mean of their work experience was 12.8 years (SD±8.02) in different teaching specialties. Among participants, 60.2% claimed that no pupils had mental health problems in their classes, 80.1% had not referred any pupils to mental health facilities, and 88.5% did not receive any training related to childhood mental health problems. A humble percent (12.2%) of the participants claimed a good awareness of the signs and symptoms of childhood disorders. Only 54% of teachers advise visiting a psychiatric clinic in case of psychiatric problems, and a similar percentage of teachers believe that psychiatric drugs cause addiction. The male gender, being specialized in humanitarian subjects, having relatives or friends with childhood mental disorders, and receiving training related to childhood mental health were significantly associated with teachers' better awareness. Conclusion Primary school teachers generally lack awareness of childhood mental health and have underestimation and poor recognition of cases of mental disorders. There are many teachers who also have unfavorable attitudes toward psychiatric disorders, patients, and treatments, which requires much effort to improve their awareness and attitudes toward childhood mental disorders.

Infected giant right seminal vesicle epidermoid cyst in young male patient with ipsilateral solitary kidney: Case report.

This case report presents a young male patient with a 3-month history of a rapidly growing lower abdominal mass associated with lower urinary tract symptoms and recurrent urinary tract infection. Pelvic magnetic resonance imaging showed a large congenital cyst in the right seminal vesicle having a mass effect on the urinary bladder, rectum, and left ureter. Histopathologic findings from exploratory laparotomy showed an epidermal inclusion cyst with secondary inflammation and suppuration. This report adds to the literature by describing this unique location of an epidermoid cyst within the seminal vesicle.

Extraction of a Foreign Body From the Middle Ear Following a Complicated Hearing Aid Fitting: A Case Report.

Ear molding is a safe way to evaluate the ear for hearing aid fitting. A very rare complication of ear molding is the entry of a foreign body into the middle ear. We report the case of a three-year-old boy who had a perforated left tympanic membrane and bilateral sensorineural hearing loss that required the use of hearing aids. During the ear molding procedure, the molding material was unintentionally introduced into his middle ear cavity, necessitating immediate surgery to remove it. Such patients with tympanic membrane perforation must be handled cautiously while an aural impression is taken via ear molding to prevent introducing a foreign body into the middle ear.

Comparison of Indirect Immunofluorescence and Enzyme Immunoassay for the Detection of Antinuclear Antibodies.

OBJECTIVE: The detection of autoantibodies directed toward nuclear antigens is one of the main criteria for the diagnosis of systemic lupus erythematosus (SLE), for which the most commonly used techniques are the enzyme immunoassay and immunofluorescence assay (IFA). However, the sensitivity and specificity of these tests vary between different techniques. Thus, in this study, we aimed to determine the superior method for detecting antinuclear antibodies (ANAs) and compare the accuracy of tests ordered by rheumatologists versus non-rheumatologists. MATERIALS AND METHODS: We compared the sensitivity and specificity of the two assays in 149 patients from a non-selected population, who were sent to the immunology laboratory of King Abdulaziz Medical City, Jeddah from 2018 to 2019. RESULTS: The sensitivity and specificity of the indirect IFA were 77.78 % and 58.65%, respectively. The positive and negative predictive values of IFA for SLE were 44.87% and 85.92%, respectively. The sensitivity and specificity of the enzyme-linked immunosorbent assay (ELISA) were 77.78% and 80.77%, respectively. The negative and positive predictive values of ELISA for SLE were 63.64% and 89.36%, respectively. The highest number of false-positive IFA tests was requested by family physicians and the lowest was requested by rheumatologists. CONCLUSION: Our data show that IFA has a higher negative predictive value, while ELISA has a higher positive predictive value. The positive predictive value of the test can be improved by pre-selecting patients by specialist rheumatologists.

Assessment of Hydration Status and Blood Pressure in a Tertiary Care Hospital at Al-Khobar.

Background High blood pressure is a major cardiovascular risk factor. It is a leading cause of increasing morbidity and mortality worldwide. One-third of the adult population worldwide suffers from hypertension. Salt intake, obesity, decreased physical activity, and smoking are well known to increase blood pressure. Fluid retention is the main contributing factor to primary hypertension and adversely affects the cardiovascular system. The emerging evidence suggests a relationship between blood pressure and hydration status. Our study aims to assess the correlation between hydration status and blood pressure. We aim to assess the hydration status in subjects with normal and high blood pressure and to investigate the association of hydration status with hemodynamic measurement. Methodology This cross-sectional and observational study included adult (>18 years) male and female subjects who agreed to participate. In total, 235 subjects were recruited by convenience sampling from (1) patients and caregivers attending geriatric and internal medicine clinics, and (2) visitors coming to King Fahad University Hospital at Al-Khobar. There were five patients on oral diuretics who were excluded from the study. Data were collected from September 2021 to March 2022. Hydration status was measured by a bioelectrical impedance analyzer (Bioscan 920, Maltron International Ltd. Rayleigh, UK). Hemodynamic measurements included heart rate per minute, systolic blood pressure, diastolic blood pressure, pulse pressure (the difference between systolic and diastolic blood pressure), and mean arterial pressure calculated as blood diastolic pressure plus one-third of pulse pressure. Statistical analyses were performed using SPSS statistics for windows, version 28.0 (IBM Corp., Armonk, NY, USA). Descriptive data were reported using means with standard deviations for numerical data and relative frequencies (percentage) for categorical data. P-values of less than 0.05 were considered statistically significant. Comparison between groups was done using a one-way analysis of variance test. Results Extracellular water percentage was higher in hypertensive (45.0 ± 2) than prehypertensive (43.5 ± 3) or normotensive (43.0 ± 2) (p = 0.001) subjects. In contrast, intracellular water percentage and total body water percentage were significantly negatively related to hypertension status. Conclusions Our results have shown a strong association between hypertension status and hydration parameters. In our study, hypertensive subjects tended to have lower total body water percentage and intracellular water percentage (bioimpedance value) than normotensive subjects. This might promote more research regarding the relationship between hypohydration and cardiovascular disease pathophysiology. This outcome should raise awareness about proper hydration as hypohydration can be a causative factor for hypertension.

Patterns of self-reported recovery from chemosensory dysfunction following SARS-CoV-2 infection: insights after 1 year of the pandemic.

BACKGROUND: The coronavirus disease (COVID-19), due to the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), causes chemosensory dysfunction. AIMS/OBJECTIVES: To determine the characteristics of chemosensory dysfunction and to identify factors associated with chemosensory complete recovery and time to recovery. MATERIALS AND METHODS: This cross-sectional study included all patients presenting with chemosensory dysfunction and confirmed SARS-CoV-2 infection from May to August 2020 who underwent telemedicine follow-up after 1 year to assess their chemosensory recovery. RESULTS: A total of 372 patients were included, of which 53.8% were male. The mean age ± SD was 37.45 ± 13.44. The majority experienced combined (olfactory and gustatory) dysfunction (85.7%), and 315 patients (84.7%) had complete loss of chemosensory function. The independent predictors associated with a low likelihood of complete recovery were parosmia (aOR 0.16, p < .001), upper respiratory tract symptoms (aOR 0.28, p = .001), and dyspnoea (aOR 0.21, p < .001), whereas the factors associated with a long recovery period were parosmia (aOR 12.04, p = .002), headache (aOR 7.19, p = .007), and hypertension (aOR 7.76, p = .039). CONCLUSIONS: A full recovery outcome was predominant. The presence of parosmia was linked to both an incomplete recovery and a long time to recovery. SIGNIFICANCE: Parosmia and respiratory symptoms are implicated in the incomplete recuperation of chemosensory function.

Foot Function Index for Arabic-speaking patients (FFI-Ar): translation, cross-cultural adaptation and validation study.

BACKGROUND: Foot Function Index (FFI) is a valid and reliable outcome measure, which is widely used to measure the foot and ankle functional level and disorders. Until now, no validated Arabic version of the FFI is available. This study was conducted at a tertiary care hospital in Riyadh, Saudi Arabia. The purpose of this project was to translate and adapt the FFI into Arabic and to evaluate its psychometric properties of validity and reliability. METHODS: The study consisted of two phases. The first phase was the translation and cultural adaptation of the FFI to Arabic. The next phase involved, testing the psychometric properties of the Arabic version of the FFI on a sample of 50 consecutive participants which included internal consistency, test-retest reliability, floor and ceiling effects and construct validity. RESULTS: The mean age of the study participants was 38 ± 12.94 years. Both the genders were evenly enrolled with 50% of the participants as male and 50% as female. Majority of them complained of plantar fasciopathy (32%) followed by pes planus (22%) and ankle sprain (18%). The scores of FFI-Ar were normally distributed, confirmed by a significant Shapiro-Wilk test. The mean value of FFI-Ar total score was 47.73 ± 19.85. There were no floor or ceiling effects seen in any of the subscales and total score. The internal consistency was good with the Cronbach's alpha value of 0.882, 0.936 and 0.850 for the pain, disability and activity limitation subscales, respectively. The reproducibility of the FFI-Ar was analysed by intra-class correlation coefficient which revealed good to excellent test-retest reliability. A significant correlation was found between FFI-Ar and SF-36 and numeric rating scale (NRS) confirming its construct validity. CONCLUSION: The FFI-Arabic version showed good validity and reliability in patients with foot and ankle problems. This tool can be used in usual practice and research for analysing foot and ankle disorders in Arabic-speaking people.

The The Impact of Surgical Revascularization on Cardiac Function and Mitral Regurgitation in Patients with Coronary Artery Disease: An Intermediate-Term Single-Center Experience.

INTRODUCTION: Ischemic heart disease is the most common cause of death worldwide. Coronary artery bypass grafting (CABG) is the most performed cardiac surgical procedure. Studies have shown that CABG can have a beneficial effect on left ventricular ejection fraction (LVEF) and ischemic mitral regurgitation (IMR) without intervention on the mitral valve. This study aims to assess changes in LVEF and IMR after CABG in our population. METHODS: We retrospectively reviewed charts of patients who underwent only CABG at King Faisal Cardiac Center in Jeddah between January 2016 and December 2019 (N = 298). Pre- and postoperative echocardiography data were evaluated. Changes in cardiac function and mitral regurgitation were analyzed. RESULTS: CABG was performed on 298 patients. The median age was 61 years (interquartile range (IQR)= 54-68), and 78.5% of the patients were male. The median body mass index was slightly higher in females (32.9 vs. 28.6 kg/m2, P = 0.089). Approximately 81% of patients had diabetes and hypertension, but only 24% were active smokers. The median time between pre- and postoperative echocardiography was 8 months (IQR= 3-17). The median preoperative LVEF was 51% (IQR= 44.1-57.9), and 75% of patients had normal-to-mild MR. The median postoperative EF was not different among patients who underwent echocardiography within or after 6 months (53.1% and 50.3%, respectively, P = 0.454). None of the patients progressed to severe MR after surgery, and only 2.7% had moderate-to-severe MR at follow up. Postoperative in-hospital mortality was 0.7%. CONCLUSION: Based on international guidelines and the best evidence, surgical revascularization is sufficient for patients with coronary artery disease (CAD) with moderate IMR and is not associated with LVEF worsening or MR progression. Complete revascularization might have an influence on ventricular recovery that might improve or stabilize IMR. Our results are consistent with larger studies reporting very low postoperative mortality of this high-risk patient group.

Effects of Wild Yam Root (Dioscorea villosa) Extract on the Gene Expression Profile of Triple-negative Breast Cancer Cells.

BACKGROUND/AIM: Wild yam extract [Dioscorea villosa, (WYE)] is consistently lethal at low IC50s across diverse cancer-lines in vitro. Unlike traditional anti-cancer botanicals, WYE contains detergent saponins which reduce oil-water interfacial tensions causing disintegration of lipid membranes and causing cell lysis, creating an interfering variable. Here, we evaluate WYE at sub-lethal concentrations in MDA-MB-231 triple-negative breast cancer (TNBC) cells. MATERIALS AND METHODS: Quantification of saponins, membrane potential, lytic death and sub-lethal WYE changes in whole transcriptomic (WT) mRNA, miRNAs and biological parameters were evaluated. RESULTS: WYE caused 346 differentially expressed genes (DEGs) out of 48,226 transcripts tested; where up-regulated DEGS reflect immune stimulation, TNF signaling, COX2, cytokine release and cholesterol/steroid biosynthesis. Down-regulated DEGs reflect losses in cell division cycle (CDC), cyclins (CCN), cyclin-dependent kinases (CDKs), centromere proteins (CENP), kinesin family members (KIFs) and polo-like kinases (PLKs), which were in alignment with biological studies. CONCLUSION: Sub-lethal concentrations of WYE appear to evoke pro-inflammatory, steroid biosynthetic and cytostatic effects in TNBC cells.

Blood donation among university students: practices, motivations, and barriers in Saudi Arabia.

CONTEXT: Blood transfusion is an essential medical procedure conducted with various purposes to provide patients with blood needed. The procedure saves patients' lives, as blood cannot be manufactured artificially and can only be obtained from human blood sources. AIMS: To assess the awareness of, perceptions of, motivations regarding, and barriers to blood donation among a sample of Jazan University students in the Kingdom of Saudi Arabia (KSA). SETTINGS AND DESIGN: An observational cross-sectional study was conducted among the undergraduate students of Jazan University. MATERIALS AND METHODS: Stratified random sampling was used to collect information from 440 students, and a predesigned, structured questionnaire was used to collect data on the study variables. STATISTICAL ANALYSIS: Involved descriptive statistics and inferential statistics. SPSS was used for data analysis. RESULTS: The prevalence of blood donation was 29.0% (95% CI, 25.0-33.3), significantly higher for males at 44.3% (95% CI, 38.3-50.4) than for females at 10.5% (95% CI, 7.3-16.0; P < 0.001), and with odds ratio (OR) = 6.8; [95% CI, 4.1-11.2] than females. Students' level of knowledge regarding blood donation was low. The main barriers to blood donation were identified as being unqualified for blood donation (57.5%) and risk of contracting infectious disease (48.7%) and the desire to donate in the future to a close friend (38.6%). The main motivations for donating blood were identified as religious reasons (77.5%), altruism (77.5%), and to serve the homeland and meet the call of need (77.5%). CONCLUSIONS: The prevalence of blood donation was found to be low, and students' knowledge regarding blood donation appeared to be lacking. The development of awareness programs among the university's students will address students' misconceptions about blood donation and encourage them to join donation campaigns.

Serum uric acid as a sensitive concordant marker with lupus nephritis and new onset of renal damage: a prospective cohort study.

OBJECTIVE: The objectives of this study are to assess serum different uric acid levels among systemic lupus erythematosus patients with or without active lupus nephritis in comparison to healthy controls and to study the relation of baseline uric acid levels to the development of new-onset renal damage in lupus nephritis. METHODS: This is a case-control study followed by a prospective cohort of systemic lupus erythematosus (SLE) patients. Three groups were included; all were having normal kidney function, 25 SLE patients with recently diagnosed active lupus nephritis (LN), 26 SLE patients without LN, and 38 healthy controls. Serum uric acid (SUA)and serum creatinine were done for all groups; for SLE patients, 24-h protein in the urine, urinalysis, C3, C4 levels, anti-DNA, anti-ENA antibodies, SLE Disease Activity Index (SLEDAI), and SLICC/ACR damage index (SDI) evaluation were also calculated. Follow-up was done with clinical and laboratory assessment including SUA, with SLEDAI and SDI evaluation. RESULTS: Serum uric acid was significantly higher in SLE patients with active LN than the other two groups (p < 0.05), a cutoff value of serum uric acid associated with lupus nephritis onset was 0.41 mmol/L with a sensitivity of 58% and specificity of 100%, however, C3 and C4 showed very low sensitivity and specificity. During follow-up, all patients with LN with baseline serum uric acid ≥ 0.52 mmol/L were associated with new-onset renal damage within 43 months. CONCLUSIONS: High-serum uric acid levels showed a significant association with lupus nephritis onset and new onset of renal damage. Key Points • Serum uric acid is a cheap, rapid, and popular test available in most of the worldwide laboratories; its higher levels showed a significant association with lupus nephritis onset and new onset of renal damage • The current work is the largest study done on lupus nephritis with strict control to the confound risk factors that are associated with the increase of the uric acid levels; moreover, it is the first study to assess such relation in Saudi population • Uric acid could have a role in the pathogenesis of lupus nephritis patients and consequent renal damage.

Assessment of patient safety challenges and electronic occurrence variance reporting (e-OVR) barriers facing physicians and nurses in the emergency department: a cross sectional study.

BACKGROUND: The purpose of patient safety is to prevent harm occurring in the healthcare system. Patient safety is improved by the use of a reporting system in which healthcare workers can document and learn from incidents, and thus prevent potential medical errors. The present study aimed to determine patient safety challenges facing clinicians (physicians and nurses) in emergency medicine and to assess barriers to using e-OVR (electronic occurrence variance reporting). METHODS: This cross-sectional study involved physicians and nurses in the emergency department (ED) at King Khalid University Hospital (KKUH) in Riyadh, Saudi Arabia. Using convenience sampling, a self-administered questionnaire was distributed to 294 clinicians working in the ED. The questionnaire consisted of items pertaining to patient safety and e-OVR usability. Data were analyzed using frequencies, means, and percentages, and the chi-square test was used for comparison. RESULTS: A total of 197 participants completed the questionnaire (67% response rate) of which 48 were physicians (24%) and 149 nurses (76%). Only 39% of participants thought that there was enough staff to handle work in the ED. Roughly half (48%) of participants spoke up when something negatively affected patient safety, and 61% admitted that they sometimes missed important patient care information during shift changes. Two-thirds (66%) of the participants reported experiencing violence. Regarding e-OVR, 31% of participants found reporting to be time consuming. Most (85%) participants agreed that e-OVR training regarding knowledge and skills was sufficient. Physicians reported lower knowledge levels regarding how to access (46%) and how to use (44%) e-OVR compared to nurses (98 and 95%, respectively; p < 0.01). Less than a quarter of the staff did not receive timely feedback after reporting. Regarding overall satisfaction with e-OVR, only 25% of physicians were generally satisfied compared to nearly half (52%) of nurses. CONCLUSION: Although patient safety is well emphasized in clinical practice, especially in the ED, many factors hinder patient safety. More awareness is needed to eliminate violence and to emphasize the needs of additional staff in the ED. Electronic reporting and documentation of incidents should be well supported by continuous staff training, help, and feedback.

Safety measures for COVID-19: a review of surgical preparedness at four major medical centres in Saudi Arabia.

In view of the worldwide coronavirus disease 2019 (COVID-19) pandemic, hospitals need contingency planning. This planning should include preparation for an unexpected patient surge. This measure is evolving concomitantly with the implementation of the needed infection control rules. Here, we present our experience in contingency planning at four large tertiary hospitals in Saudi Arabia during this global pandemic, with a focus on dealing with COVID-19 patients who need to undergo surgery. The planning covers response measures required in the operating room and supporting units, including the administrative department, intensive care unit, and different sections of the surgical department. Furthermore, it covers the role of education and simulation in preparing health care providers and ensuring smooth workflow between all sections. We additionally discuss the guidelines and policies implemented in different surgical specialties. These measures are necessary to prevent the transmission of COVID-19 within healthcare facilities. Throughout the COVID-19 pandemic, the healthcare system should develop a comprehensive pandemic plan and set guidelines addressing the management of urgent and malignant cases. The guidelines should be in concordance with internal guidelines.

Percutaneous Nephrolithotomy in a Patient with Cross-Fused Renal Ectopia.

Background: Cross-fused renal ectopia (CFRE) is a rare congenital anomaly in which an ectopic kidney crosses the midline and merges with the orthotopic kidney on the other side. Patients with CFRE could present with urolithiasis. The abnormal anatomy and the lack of consensus to treat urolithiasis in these cases present challenges to treatment. In this study, we present a case of renal stone in a CFRE managed through percutaneous nephrolithotomy (PCNL). Case Presentation: We present a case of a 59-year-old man with right flank pain. Radiologic studies showed a 2 cm renal pelvis stone in a CFRE. The patient was effectively managed with PCNL. Conclusion: With proper radiologic study and thorough understanding of the aberrant anatomy, PCNL represents a safe and effective treatment for patients with renal stones in CFRE with high stone-free rate and low mortality.

The diagnostic yield of the routine EEG at a tertiary care center in Saudi Arabia: A retrospective study.

BACKGROUND: The Routine Electroencephalography (REEG) records cerebral electrical activity to aid in the diagnosis and classification of Epilepsy. Indiscriminate use of the REEG may lower its clinical yield. The pretest clinical variables contributing to the yield of the REEG outcome have not been well-established in the context of developing healthcare systems where REEG utilization may differ from well-established centers. The aim of this study is to determine the yield of the REEG and the pretest clinical variables predicting the yield of the REEG at a single center in the context of the developing healthcare system in Saudi Arabia. MATERIALS AND METHODS: We reviewed REEG reports at a single center in Jeddah, Saudi Arabia between 2015 and 2018. We collected demographic and clinical data from the patients' electronic files. Patients of age ≥18-year-old were included. We collected age, gender, nationality, the indication for the REEG, co-morbidities, antiseizure medicines (ASMs), and details related to the yield of the REEG (normal or abnormal, epileptiform or non-epileptiform, focality, and the presence of rhythmic or periodic patterns or seizures). RESULTS: We included 500 records. Fifty-nine percent were females. The mean age was 39 ±â€¯17 years. Of the recorded REEGs, 42.4% were abnormal, 14.6% of them showing definite epileptiform discharges and 85.4% showing only slowing. Half of the REEGs of individuals previously diagnosed with epilepsy revealed abnormal findings. ASM use was associated with slowing in the REEG (p < .05). Using logistic regression, history of a previous stroke and use of carbamazepine or lamotrigine were predictors of the presence of abnormalities in the REEG, while use of ≥2 ASMs predicted the presence of epileptiform discharges. Stroke also predicted abnormal slowing alongside increased age. CONCLUSION: The clinical yield of the REEG in this sample of patients from a single institution in the context of a developing healthcare system was relatively low. History of stroke and being on more than one ASM may predict that the REEG will show relevant abnormalities.

Depression Among First- and Fifth-Year Medical Students in Riyadh, Saudi Arabia.

BACKGROUND: Depression, which is characterized by persistent sadness, is a highly prevalent and serious medical disease that affects more than 300 million individuals worldwide. It is hypothesized that the onset of depressive symptoms in medical students occurs due to prolonged exposure to the stressful environment of medical colleges. Hence, we aimed to determine the presence of depressive symptoms and compare the level of depression between the first-year and fifth-year medical students in Riyadh city, Saudi Arabia. MATERIALS AND METHODS: This cross-sectional study was performed with convenient sampling from 2 medical colleges in Riyadh in the Kingdom of Saudi Arabia from October to November 2017. The English version of Beck's Depression Inventory questionnaire was used in this study. Statistical analysis was administered using SPSS via chi-square test, and P-value less than 0.05 was considered statistically significant. RESULTS: The questionnaire was answered by 241 participants. The age variable shows a bimodal distribution. The mean age of first-year and fifth-year students was 19±0.8 years and 23±2.1 years, respectively. Fifth-year students comprised 53.5% of the total sample, and male students accounted for 63.1% of the total sample. After analysis, the results show that male students scored higher than female students on the lower side of the scale in both years. Most of the first-year female students scored a higher level of depression compared with male students (P=0.001), whereas no difference between males and females (P=0.04) was found in the fifth-year students' data. CONCLUSION: Our study shows a new pattern of reported depressive symptoms among first-and fifth-year medical students. In addition, the study suggests that depression is more common in female medical students as compared with their male counterparts. For future studies, we recommend using randomized sampling in a cohort study including all levels of medical students to further investigate and confirm the findings.

Depression among medical students in Saudi medical colleges: a cross-sectional study.

INTRODUCTION: Major depressive disorder is a common mental disorder worldwide that has many clinical presentations and is associated with many diseases. The aim of this study is to assess the levels of depression among medical students in Saudi medical colleges. METHODS: A cross-sectional study with a convenience sample conducted in Saudi medical colleges. Patient Health Questionnaire-9 (PHQ-9) was used for screening and associated with sociodemographic characteristics. RESULTS: A total of 2,562 medical students from 20 universities were recruited into this study, and 1,572 (61.4%) of the participants were females and 990 (38.6%) were males. Depression symptoms are found to be associated with college years, living conditions and smoking status (P<0.05). CONCLUSION: High levels of depression symptoms were found among Saudi medical students (83.4%). Students in the first years of college should be screened for depression, while education and support for medical students in these years are essential.