Diagnosis of Small Intestinal Diaphragms and Strictures Induced by Non-steroidal Anti-inflammatory Drugs Through Intraoperative Enteroscopy: A Case Study From Saudi Arabia.

The small intestinal diaphragms are a rare condition characterized by focal or diffuse luminal narrowing in the small intestine. Nonsteroidal anti-inflammatory drugs (NSAIDs) have been associated with the development of small intestinal diaphragms, particularly in long-term and high-dose users. In the current report, a Saudi adult female complained of abnormal bowel motions, which caused severe abdominal pain. She had long-term treatment with NSAID. Systemic and physical examination was unremarkable, apart from poorly localized, nonspecific tenderness to abdominal palpation. Two endoscopic investigations (upper and lower endoscopy) were performed to identify any abnormalities in the digestive system; also, a biopsy was taken for histopathological analysis. In addition, another capsule endoscopy was done to investigate any abnormal bowel motion. The findings of two endoscopic investigations and histopathological analysis of duodenum biopsies revealed different features of small intestinal diaphragms and stricture. The biopsies showed mild chronic inflammation. The esophagogastroduodenoscopy (EGD) and colonoscopy showed multiple strictures and ulcerations in the small bowel. Also, a diffused mucosal erythema of the stomach and a remarkable scar on the third part of the duodenum were detected. That might be due to the excessive use of NSAIDs. The investigations revealed multiple small bowel diaphragmatic stenosis and strictures in the proximal and distal small bowel. These are distinct signs of NSAID-induced small bowel diaphragms and strictures.

Simulation-Based Teaching and Learning in Respiratory Care Education: A Narrative Review.

Simulation-based pedagogy has become an essential aspect of healthcare education. However, there is a significant gap in the literature regarding the application of simulation-based modalities in respiratory care education. This review aims to address this gap by providing insight into the theory and current uses of simulation, its effectiveness in respiratory care education, and strategies to enhance faculty development. The study utilizes a narrative synthesis approach to review relevant literature and provide a comprehensive understanding of the topic. The research involved comprehensive searches of electronic databases, including PubMed and Google Scholar, to identify relevant literature, encompassing original articles, reviews, and other pertinent content, focusing on simulation-based teaching and learning in respiratory care education published between 1990 and 2022. Findings suggest that simulation-based education is an effective tool for improving respiratory care education and can enhance the clinical skills of learners. The study concludes by discussing the future of simulation in respiratory care education and the potential benefits it may offer.

The effect of cumulative night shift duties on insomnia, fatigue, and mental health in intensive care unit.

Background: Night shift duties are crucial in the ICU to ensure care continuity, where critically ill patients require round-the-clock care. However, cumulative night shift duties may disturb circadian rhythm, insomnia, fatigue, and depression, and require further elucidation. Objectives: This study aims to examine the negative consequences of various night shift patterns on insomnia, fatigue, and mental health of ICU Workers. Methods: A cross-sectional study examined how cumulative night shift duty affects insomnia, fatigue, and mental health in critical care providers (CCPs). Results: A total of 1006 participants completed this study between June 2022 and March 2023, including 54.5 % males. About 35 % were between 20 and 30 years of age, and Respiratory Therapists accounted for approximately 46.5 % of the entire sample. Most of our respondents (476; 47 %) reported working night shifts, with a monthly range of 8-15 nights. The prevalence rates for moderate to severe clinical insomnia, fatigue, and moderate to severe depression were 42 %, 48 %, and 32 %, respectively. CCPs working 8-15 nights had a 2-fold risk of clinical insomnia than those working fewer than eight nights with (AOR) and 95 % (CI) of 2.12 and 1.41-3.20, while those working ≥16 nights per month had a greater incidence of clinical insomnia compared to those working <8 nights per month, AOR (CI): 3.09 (1.90-5.03). Only those working ≥16-night shifts per month had a substantially higher fatigue risk compared to those working < 8-night shifts per month, with an AOR (CI) of 1.92 (1.19-3.08). Working 8-15-night shifts per month increases depression risks by 34 % compared to the <8-night shifts group, AOR (CI): 1.34 (0.87-2.08). Those working ≥16-night shifts per month showed a higher depression risk than those working <8-night shifts, AOR (CI): 2.53 (1.53-4.19). Conclusion: A cumulative night shift above eight nights per month is linked with an increased risk of insomnia, fatigue, and depression. The risk of these conditions was significantly directly proportional to the number of night shifts performed per month.

Key Performance Indicators: A Framework for Allied Healthcare Educational Institutions.

Background: Performance evaluation in the allied healthcare education sector is complex, making it essential for policymakers and managers to approach it comprehensively and thoughtfully to understand their performance. Hence, the development and monitoring of Key Performance Indicators (KPIs) in this domain must be considered one of the key priorities for the policymakers in AHIs. Aim: This study aims to develop a framework for the AHIs to extract and profile the indicators, measure, and report the results appropriately. Methods: The authors adopted a general review of the literature approach to study the primary goals of the institutional KPI framework, emphasizing the need for benchmarking while implementing KPIs and how to track performance using a KPI dashboard. Results: The study provides the scope, relevant KPI categories, and a list of KPIs for evaluating the effectiveness of allied healthcare programs. The study findings also emphasized the need for benchmarking the KPIs and establishing a KPI dashboard while measuring and monitoring performance. Conclusion: KPIs are considered an invaluable tool that contributes immensely to the performance monitoring process of AHIs, irrespective of the specialties. This helps to identify and guide AHIs for developing KPIs and the associated minimum data set to measure organizational performance and monitor the quality of teaching and learning. In addition, the KPI framework reported in this study is a tool to assist performance monitoring that can subsequently contribute to the overall quality of AHIs.

A population-based study of 15,000 people on Knowledge and awareness of lung cancer symptoms and risk factors in Saudi Arabia.

Background: Lung cancer is currently the most fatal form of cancer worldwide, ranking as the fourth most prevalent type in Saudi Arabia, particularly among males. This trend is expected to increase with growing population, lifestyle changes, and aging population. Understanding the awareness of the Saudi population regarding the risk factors and symptoms of lung cancer is necessary to attenuate the predicted increase in cases. Method: A cross-sectional, population-based survey was performed using a previously validated questionnaire (Lung CAM). Multiple linear regression analysis was used to assess variables associated with deficiency in knowledge and awareness of risk factors and symptoms of lung cancer. Results: Majority of the 15,099 respondents were male (65%), aged between 18 and 30 years (53%), 50% of which were educated up to a bachelor's degree level. Overall awareness of lung cancer signs and symptoms was 53%, with painful cough and coughing up blood being the best-known symptoms. Conversely, persistent shoulder pain (44%) and clubbing fingers (47%) were the least known lung cancer symptoms. Also, 60% of the respondents showed low confidence in identifying the signs and symptoms of lung cancer. The overall awareness of the risk factors for lung cancer development was 74%, with first-hand (74%) and second-hand (68%) smoking being the most known risk factors. However, only ≤ 62% know the other non-smoking risk factors. Awareness of the risk factors and symptoms of lung cancer depended on age, gender, education, marital and employment status (p < 0.001). Conclusion: Public awareness of the risk factors and symptoms of lung cancer in Saudi Arabia is inadequate and heavily dependent on education and socio-economic status. Awareness can be improved through campaigns to raise awareness about other lesser-known lung cancer risk factors and symptoms.

Correlation Between C-Reactive Protein and Lipid Analytes in Dry Age-Related Macular Degeneration: A Retrospective Study.

INTRODUCTION: To date few studies have investigated the correlation between inflammatory markers and lipoproteins in the serum of age-related macular degeneration (AMD) patients, often reporting conflicting findings. This study aimed to investigate the correlation between lipid analytes and C-reactive protein (CRP) levels in individuals diagnosed with dry AMD. METHODS: A standard clinical lipid panel (total cholesterol, triglycerides, high-density lipoprotein [HDL], and low-density lipoproteins) and CRP laboratory results were retrospectively collected from the medical records of patients with dry AMD and age- and sex-matched controls. RESULTS: The study included 90 patients with dry AMD and 270 patients without AMD. In univariate analysis, CRP showed a higher mean value in cases than in controls. After adjusting for age and sex, CRP and triglyceride levels showed significant differences between cases and controls. Pearson's correlation analysis revealed a significant negative correlation between CRP and HDL levels in the dry AMD group (n=90). Other lipid analytes showed no significant correlations with CRP. CONCLUSION: Our findings add to the growing body of evidence linking inflammation to AMD. Although it is unclear whether changes in serum CRP and triglyceride levels are the causes or effects, monitoring both analytes may be beneficial as an early disease predictor, especially in individuals with a family history of AMD. The negative correlation between CRP and HDL (i.e., inflammation and good cholesterol) may be targeted for future therapies.

Perspectives, practices, and challenges of online teaching during COVID-19 pandemic: A multinational survey.

The result of the movement restrictions during the COVID-19 pandemic was an impromptu and abrupt switch from in-person to online teaching. Most focus has been on the perception and experience of students during the process. The aim of this international survey is to assess staffs' perspectives and challenges of online teaching during the COVID-19 lockdown. Cross-sectional research using a validated online survey was carried out in seven countries (Brazil, Saudi Arabia, Jordan, Indonesia, India, the United Kingdom, and Egypt) between the months of December 2021 and August 2022, to explore the status of online teaching among faculty members during the COVID-19 pandemic. Variables and response are presented as percentages while logistic regression was used to assess the factors that predict levels of satisfaction and the challenges associated with online instruction. A total of 721 response were received from mainly male (53%) staffs. Most respondents are from Brazil (59%), hold a Doctorate degree (70%) and have over 10 years of working experience (62%). Although, 67% and 79% have relevant tools and received training for online teaching respectively, 44% report that online teaching required more preparation time than face-to-face. Although 41% of respondents were uncertain about the outcome of online teaching, 49% were satisfied with the process. Also, poor internet bandwidth (51%), inability to track students' engagement (18%) and Lack of technical skills (11.5%) were the three main observed limitations. Having little or no prior experience of online teaching before the COVID-19 pandemic [OR, 1.58 (95% CI, 1.35-1.85)], and not supporting the move to online teaching mode [OR, 0.56 (95% CI,0.48-0.64)] were two main factors independently linked with dissatisfaction with online teaching. While staffs who support the move to online teaching were twice likely to report no barriers [OR, 2.15 (95% CI, 1.61-2.86)]. Although, relevant tools and training were provided to support the move to online teaching during COVID-19 lockdown, barriers such as poor internet bandwidth, inability to track students' engagement and lack of technical skills were main limitations observed internationally by teaching staffs. Addressing these barriers should be the focus of higher education institution in preparation for future disruptions to traditional teaching modes.

Biofeedback Training after Successful Inverted Internal Limiting Membrane (ILM)-Flap Technique for High Myopic Macular Hole.

BACKGROUND: Microperimetric biofeedback training improved visual acuity and fixation stability in patients who previously underwent macular surgery. We aimed to compare the functional results of biofeedback training with the standard of care in patients who underwent successful inverted Internal Limiting Membrane (ILM)-flap technique for high myopic macular holes (hMMH). METHODS: This was a retrospective, comparative, cohort study. Patients with hMMH after surgical hole closure underwent microperimetric biofeedback using structured light stimulus plus acoustic tone (n = 12; Biofeedback) or standard of care with scheduled visits (n = 11; Control). Best-corrected visual acuity, retinal sensitivity at central 12° (RS) and 4° (CRS) with a mean deviation at central 12° (MD), and fixation stability as bivariate contour ellipse area (BCEA 68%, 95%, and 99%) were assessed at baseline and month 1, 3, 6, and 12. The Mann-Whitney test was used to test the difference between the groups. RESULTS: Baseline functional parameters were not significantly different among the groups. BCVA significantly improved in each group (Biofeedback, p = 0.002; Control, p ≤ 0.02) at all follow-up visits. CRS significantly improved at 6 (p = 0.03) and 12 (p = 0.01) months in the Biofeedback group and at month 12 (p = 0.01) in the Control group. RS (p = 0.001) and MD (p = 0.005) improved at the last follow-up only in the trained group. After training, BCEA 68% and 95% significantly improved (6 and 12 months, p < 0.05). The Biofeedback group had better results in RS (p ≤ 0.02), CRS (p ≤ 0.02), and BCEA 68%, 95%, and 99% (p ≤ 0.01) compared to the Control at all follow-ups. BCVA and MD were better in the Biofeedback group at month 3 (p = 0.01), and month 3 (p = 0.01) and 12 (p = 0.003), respectively. CONCLUSIONS: Microperimetric biofeedback can increase retinal sensitivity and stabilize fixation better than the standard care over months after a successful inverted ILM-flap for hMMH.

The Association of Body Mass Index with COVID-19 Complications and Survival Rate at a Tertiary Hospital.

A high body mass index (BMI) is a known risk factor for coronavirus infection in hospitalized patients. Our study examined the association between BMI and complications and the survival rate among COVID-19 patients. This retrospective analysis used data from a tertiary hospital in the Eastern Region of Saudi Arabia during two waves of the COVID-19 pandemic. The study included 600 participants, with the majority being between 41 and 60 years old (41.3%) and men comprising 63.5% of the sample. Approximately 42.5% of patients were obese, and 31.3% were overweight. The results showed that BMI was significantly linked to respiratory diseases (p = 0.013); end-stage renal disease (p = 0.021); and cardiovascular disease (p = 0.003) but not diabetes mellitus (p = 0.064). Death occurred in 10.8% of patients; 33.8% were admitted to the ICU; 13.8% needed mechanical ventilation; and 60.7% had lung infiltration. Obese patients with oxygen saturation levels below 93% were 2.45 times more likely to require mechanical ventilation than those in the normal-weight group. Overweight and obese patients were also more likely to require mechanical ventilation than normal-weight patients, with odds ratios of 3.66 and 2.81, respectively. The BMI categorized was not associated with survival rate in COVID-19-hospitalized patients using Kaplan-Meier survival plots (p = 0.061). However, the BMI categorized was associated with survival rate in COVID-19 ICU patients (p < 0.001). In addition, the overweight showed a statistically significant higher hazard ratio of 2.22 (p = 0.01) compared to normal-weight patients using a Cox regression model. A high BMI was identified as an independent risk factor for reduced oxygen saturation (<93%), the need for mechanical ventilation, lung infiltration, mortality, and longer ICU stays in COVID-19 patients.

Self-reported long COVID-19 symptoms are rare among vaccinated healthcare workers.

INTRODUCTION: COVID-19 pandemic adversely affected healthcare workers (HCWs). Here, we evaluate the occurence of long-COVID-19 symtoms among HCWs. METHODS: This is a questionnaire-based study of HCWs who had COVID-19 in two medical centers in Saudi Arabia and were mostly vaccinated. RESULTS: The study included 243 HCWs with a mean age (+ SD) of 36.1 (+ 7.6) years. Of them, 223 (91.8%) had three doses of COVID-19 vaccine, 12 (4.9%) had four doses, and 5 (2.1%) had two doses. The most common symptoms at the start of the illness were cough (180, 74.1%), shortness of breath (124, 51%), muscle ache (117, 48.1%), headache (113, 46.5%), sore throat (111, 45.7%), diarrhea (109, 44.9%) and loss of taste (108, 44.4%). Symptoms lasted for< one week in 117 (48.1%),> one week and< 1 month in 89 (36.6%),> 2 months and< 3 months in 9 (3.7%), and> 3 months in 15 (6.2%). The main symptoms present> 3 months were hair loss (8, 3.3%), cough (5, 2.1%), and diarrhea (5, 2.1%). A binomial regression analysis showed no relationship between persistence of symptoms for> 3 months and other demographic or clinical symptoms characteristics. CONCLUSION: The study showed a low rate of the occurence of long-COVID> 3 months during the Omicron-wave among mostly vaccinated HCWs with no significant comorbidities. Furhter studies are needed to examine the effect of different vaccines on long-COVID-19 among HCWs.

Masquerade of Leukemic Infiltration With Cerebral Sinus Venous Thrombosis Causing Papilledema by Asparaginase Therapy.

Acute lymphoblastic leukemia (ALL) is a hematological cancer that can cause ocular tissue involvement. Asparaginase is a chemotherapy regimen that is commonly used in leukemia which could lead to similar ocular manifestations. We report a patient with a history of ALL for seven months on asparaginase therapy and persistent cerebral sinus venous thrombosis (CSVT) with acute venous infarction in the left frontal lobe presented with worsening vision. On examination, he had a visual acuity (VA) of (6/21) in the right eye and (6/60) in the left eye, with a mild left eye abduction limitation. Fundal examination showed bilateral prominent multilayered retinal hemorrhages and papilledema with absence of leukemic infiltration. His chemotherapy regimen was held and a one month follow up was scheduled. Follow up after one month of chemotherapy cessation showed resolution of both VA and fundal exam findings. It is crucial to differentiate between asparaginase toxicity and infiltration of the disease in ALL patients. As this would determine whether the treatment should be continued or suspended.

Impact of Smoking Status and Nicotine Dependence on Academic Performance of Health Sciences Students.

Background: Smoking behavior has been associated with poor academic performance among adult students worldwide. However, the detrimental effect of nicotine dependence on several students' academic achievement indicators is still unclear. This study aims to assess the impact of smoking status and nicotine dependence on grade point average (GPA), absenteeism rate and academic warnings among undergraduate health sciences students in Saudi Arabia. Methods: A validated cross-sectional survey was conducted, in which, participants responded to questions evaluated cigarette consumption, urge to consume and dependency, learning performance, days of absentees, and academic warnings. Results: A total of 501 students from different health specialties have completed the survey. Of whom, 66% were male, 95% ranging between the age of 18-30 years old, and 81% reported no health issues or chronic diseases. Current smokers estimated to be 30% of the respondents, of which 36% revealed smoking history of 2-3 years. The prevalence of nicotine dependency (high to extremely high) was 50%. Overall, smokers had significantly lower GPA, higher absenteeism rate, and higher number of academic warnings when compared to nonsmokers (p<0.001). Heavy smokers demonstrated significantly less GPA (p=0.036), higher days of absences (p=0.017), and more academic warnings (p=0.021) compared to light smokers. The linear regression model indicated a significant association between smoking history (increased pack-per-year) and poor GPA (p=0.01) and increased number of academic warning last semester (p=0.01), while increased cigarette consumption was substantially linked with higher academic warnings (p=0.002), lower GPA (p=0.01), and higher absenteeism rate for last semester (p=0.01). Conclusion: Smoking status and nicotine dependence were predictive of worsening academic performance, including lower GPA, higher absenteeism rate and academic warnings. In addition, there is a substantial and unfavorable dose-response association between smoking history and cigarette consumption with impaired academic performance indicators.

A systematic review and meta-analysis of heart rate variability in COPD.

Background: Chronic obstructive pulmonary disease (COPD) is associated with disruption in autonomic nervous control of the heart rhythm. We present here quantitative evidence of the reduction in HRV measures as well as the challenges to clinical application of HRV in COPD clinics. Method: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we search in June 2022 Medline and Embase databases for studies reporting HRV in COPD patients using relevant medical subject headings (MeSH) terms. The quality of included studies was assessed using the modified version of the Newcastle-Ottawa Scale (NOS). Descriptive data were extracted, while standardized mean difference was computed for changes in HRV due to COPD. Leave-one-out sensitivity test was performed to assess exaggerated effect size and funnel plots to assess publication bias. Results: The databases search yielded 512 studies, of which we included 27 that met the inclusion criteria. The majority of the studies (73%) had a low risk of bias and included a total of 839 COPD patients. Although there were high between-studies heterogeneity, HRV time and frequency domains were significantly reduced in COPD patients compared with controls. Sensitivity test showed no exaggerated effect sizes and the funnel plot showed general low publication bias. Conclusion: COPD is associated with autonomic nervous dysfunction as measured by HRV. Both sympathetic and parasympathetic cardiac modulation were decreased, but there is still a predominance of sympathetic activity. There is high variability in the HRV measurement methodology, which affects clinical applicability.

The Prevalence of Inguinal Hernia Among Athletes in Saudi Arabia: A Cross-Sectional Study.

Introduction An inguinal hernia is the most common type of hernia. It might manifest as a groin bulge, lump, or enlarged scrotum. Swelling may be uncomfortable and painful and even cause intestinal obstruction. This study aimed to measure the prevalence of inguinal hernia among athletes in Saudi Arabia. Subject and methods This is a cross-sectional study conducted among Saudi Arabian athletes. A self-administered questionnaire was distributed among athletes using an online survey through different Saudi Olympic Training and Fitness Centers throughout the kingdom. The questionnaire includes sociodemographic characteristics (i.e. age, gender, etc.), risk factors, and complications of inguinal hernia. Results Of the 594 athletes, 55.6% were females and 57.6% were aged between 18 and 24 years. The most common type of sport was running (31%). The most common risk factor for inguinal hernia was previous abdominal surgery (57.5%). The prevalence of inguinal hernia among Saudi athletes was 12.3%. Being older in age and being male were the independent significant predictors associated with increased risk for inguinal hernia, whereas weightlifting was the independent significant factor of decreased risk for inguinal hernia. Conclusion The prevalence of inguinal hernia among athletes was 12.3%. Older male athletes were most likely at a greater risk to suffer from inguinal hernia as compared to the rest of the athletes. Further research is needed to extract more data about the prevalence of inguinal hernia among Saudi Arabian athletes and determine its risk factors.

Optic Nerve Injury, Vitreous Hemorrhage, and Rhegmatogenous Retinal Detachment Following Long Needle Peribulbar Anesthesia: A Case Report and Review of the Literature.

Rhegmatogenous retinal detachment (RRD) following retrobulbar or peribulbar anesthetic injection is a rare but serious complication that often results in poor visual outcomes. Thus, extreme caution should be exercised while administering local ocular anesthesia due to the potential complications arising from local orbital anesthesia. These complications may occur locally or systemically and may arise immediately or be delayed. This case report is on a female patient who sustained optic nerve injury and RRD due to a peribulbar block administered in the setting of cataract extraction and, subsequently, experienced retinal detachment and vitreous hemorrhage at another hospital before being referred to our hospital. The retina was repaired with pars plana vitrectomy, 360 endolaser of the peripheral retina and around tears, and gas injection, achieving stable visual outcomes.

Persistent Macular Edema in a Pediatric Vogt-Koyanagi-Harada Disease Patient: A Case Report.

Vogt-Koyanagi-Harada disease (VKHD) is a rare multisystemic granulomatous disorder that mainly affects the central nervous system, eyes, inner ears, and skin, basically organs rich with melanocytes. This case report describes an 11-year-old Saudi Arabian female who presented with a six-month history of decrease in vision in both eyes associated with neck pain, right ankle pain, fatigability, and skin depigmentation. Her ophthalmological examination showed visual acuity of 6/30 oculus dextrus (OD) and 6/60 oculus sinister (OS), and her fundoscopic examination revealed vitreous opacity mainly in the right eye. Optical coherence tomography (OCT) demonstrated macular edema along with infiltration and optic edema. She was initially diagnosed as having posterior uveitis and treated with oral prednisone and steroid eye drops. A month later, her ophthalmological examination revealed a rebound of macular edema. Dosages of steroid and adalimumab injection were raised, and azathioprine was added. Her left macular edema was not resolved; therefore, an aflibercept injection was added. A differential diagnosis of VKHD needs to be considered. Any patient who presents with posterior uveitis should be screened for VKHD. Physicians and ophthalmologists need to be more aware of VKHD, as it can cause serious complications.

Effects of Omega-3 Polyunsaturated Fatty Acids on Brain Functions: A Systematic Review.

Omega is a polyunsaturated fatty acid (PUFA) that has an essential impact on cognitive performance at all stages of life. Eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and alpha-linolenic acid (ALA) are essential for brain functions. DHA, the dominant omega-3 in the brain, impacts neurotransmitters and functions of the brain. This systematic review aimed to assess the effects of omega-3 on brain functions. We searched for articles from 2010 to 2022 in PubMed, electronic databases: discover, academic search complete (EBSCO), and Cochrane. To increase search efficiency, search terms include database-specific indexed phrases and keywords. Search terms included "omega three," "DHA," "fish oil," "eicosapentaenoic acid," "EPA," "docosahexaenoic acid," "omega-3," "cognition," "brain," "mental health," and "PUFAs".We conducted a review of only randomized clinical trials (RCTs) that were published in English. We evaluated the quality of the studies using the Cochrane Collaboration bias assessment tool. Our search strategy yielded 174 articles, out of which 33 full-text articles were reviewed and nine articles were selected for data abstraction. The overall number of individuals in all nine studies was 1319. Of the participants, 591 (44.81%) were men, and 728 (55.19%) were women. Participants who received omega-3 were 700 (65.06%) compared to 376 (34.94%) who received a placebo, and their mean age was 45. Ingestion of omega-3 fatty acids increases learning, memory, cognitive well-being, and blood flow in the brain. Omega-3 treatments are advantageous, well-tolerated, and risk-free. Lonelier people, the elderly, and those who eat fewer healthy foods containing omega-3 may benefit from an omega-3 supplement. We suggest that natural omega-3 consumption through the diet should be promoted.

Routine Application of Lung Ultrasonography in Respiratory Care: Knowledge, Perceptions, and Barriers to Instigate.

Background: Lung Ultrasound (LUS) had proved to be beneficial in detecting respiratory disorders at the bedside. Understanding the important role of Respiratory Therapists (RTs) in the critical care, we aimed to assess their knowledge, perceived relevance of LUS to clinical practice, current skill gaps, and barriers to practice. Methods: A cross-sectional, nationwide survey conducted among the RTs working in the Kingdom of Saudi Arabia. The validated questionnaire included 4 sections; the demographics, knowledge and perceptions, applicability and self-reported proficiency, and barriers to the use of LUS by RTs. Results: A total of 256 RTs across different regions of Saudi Arabia participated in this survey. 71.9% of them were males, and 46.1% of the participants were having <5 years of working experience. Only (18.1%) of the participants used LUS in their clinical practice, and (43%) of them had never received any training. 66% of the participants perceived LUS as an effective tool in the RT practice and immensely valuable in their daily practice (70%). A large proportion of RTs perceived LUS to be ineffective in calculating the lung score (50.4%), assessing the diaphragm (40.2%), and detecting pulmonary edema (38.3%). Calculating lung score has a lower mean score of 2.55 on both skills, and identifying its applicability to clinical practice with a mean score of 2.71 than other indications. Lack of training and curriculum (154/256; 60.2%) remains the top barrier that prevented RTs from using LUS in their clinical practice. Conclusion: While many RTs in Saudi Arabia perceived LUS as an effective tool in the RT practice, considerable competence gap exist, indicating the need for LUS training. There is a need for incorporating LUS into the curriculum of RT schools and promoting competency-based training for the current RT workforce to help improve patient care.

Needs Assessment for the Establishment of Master's Degree Programs in Respiratory Care in the Kingdom of Saudi Arabia.

Background: Despite recent advancements in the respiratory care (RC) profession, no single institution in the Kingdom of Saudi Arabia (KSA) offers a master's degree program in RC. Methods: A nationwide and validated survey was used to explore the current needs and interests in establishing RC master's degree programs in the KSA. The process included representatives from the healthcare industry, universities, and professional societies. Results: A total of 1250 stakeholders across the KSA completed the survey. The sample includes 722 (58%) males, 504 (40%) respiratory therapists, 547 (44%) students, 138 (11%) leaders, and 61 (5%) were academic respondents. Most respondents were from Central 491 (39%) and Eastern 307 (25%) regions, with 1003 (80%) of the total sample worked or studied in governmental sectors. A total of 574 (82%) of the leaders and RTs had Bachelor degree and 430 (61%) of them had 1-5 years working experience. According to 80% of the employers and employees, only 0-5% of the RTs in their organization had a master's degree. The calculated mean % of the agreement (agree/strongly agree) on the needs was 83% in all needs' assessment items, which shows a great support for establishing a master's in RC to meet the personal, professional and society needs. The mean % of the agreement for the level of interests among all participants was 86%, indicating a great level of interests in establishing a master degree in RC. The agreement % on the needs assessment and level of interests in establishing a master degree in RC in KSA were ≥80% in each stakeholder group. Conclusion: There are obvious needs and interests in establishing master's degree programs in RC in the KSA. A master's degree in RC should be established to address the growing needs for advanced RC services throughout the nation and enhance RC research.

Health Sciences Students' Attitude, Perception, and Experience of Using Educational Simulation in Saudi Arabia: A Cross-Sectional Study.

Background: Simulation-based education (SBE) provides a safe, effective, and stimulating environment for training medical and healthcare students. This is especially valuable for skills that cannot be practiced on real patients due to ethical and practical reasons. We aimed to assess medical students' attitude, perception, and experience of simulation-based medical education in Saudi Arabia. Method: A validated cross-sectional survey, using the KidSIM scale, was conducted to measure the level of perception and experience of students from different health sciences specialties toward integrating simulation as an educational tool. Participants responded to questions investigated the importance of simulation, opportunities for Inter-Professional Education (IPE), communication, roles and responsibilities, and situation awareness. Only students with previous experience of SBE were considered for participation. Result: This survey was completed by 246 participants, of whom 165 (67%) were male students and 228 (93%) were aged between the range of 18-30 years old. Of the respondents, 104 (67%) were respiratory care students, 90 (37%) were anesthesia technology students, and 45 (18%) were nursing students. Most of the participants had previous experience in IPE simulation activities (84%), and more than half of the students (54%) had a grade point average (GPA) ranging between 5.00 and 4.50. Overall, students had positive attitudes toward and beliefs about SBE, with a mean score of 129.76 ± 14.27, on the KidSIM scale, out of 150. Students' GPA was significantly associated with a better perception to the relevance of simulation (p = 0.005), communication (p = 0.003), roles and responsibilities (p = 0.04), and situation awareness (p = 0.009). GPA is merely the sole predictor for positive attitude toward simulation with coefficient Beta value of 4.285 (p = 0.001). There were no significant correlations between other students' characteristic variables (gender, specialty, study year, experience in IPE, and prior critical care experience). Conclusion: We found that health sciences students' perception of SBE in Saudi Arabia is generally positive, and students' performance is a significant determinant of the positive perception.