Comparing students' performance in self-directed and directed self-learning in College of Medicine, University of Bisha.

Background: Student-centered learning strategy increases the likelihood of graduation of competent, self-dependent, and problem-solving physicians. The University of Bisha, College of Medicine (UBCOM) adopted self-directed learning (SDL) represented by problem-based learning (PBL), and directed self-learning (DSL) represented by team-based learning (TBL). Aim: To compare the students' performance in SDL and DSL among UBCOM students. Methodology: A total of 502 multiple choice questions (MCQs) from the mid-course and final exams were collected by the relevant subject experts from nine courses during the period from September 2020 till June 2023 that adopted PBL and TBL; 247 MCQs related to PBL and 255 related to TBL. Psychometric analysis was used to determine difficult, easy, and optimum questions (≤25%, ≥90%, and 26-89%, respectively). Point biserial as <0.19, 0.20-0.29, 0.30-0.39, and >0.40 which indicate poor, marginal, good, and excellent point biserial, respectively. Finally, the number of functional distractors was attempted by >5% of the candidates. Results: No significant differences were noted for the students' performance in MCQs related to PBL (representing self-directed, small group learning tool), and TBL (representing directed-self, large group learning tool) regarding difficulty index (DI), point biserial, and distractors functionality. Conclusion: It has been observed that there is no difference in students' performance whether PBL or TBL is used for learning Basic Medical Science courses. Small group learning such as PBL needs more resources in comparison to large group learning as in TBL, therefore any institute can decide on the adopted learning strategy depending on its resources and the number of students.

Liver Injury and Dysfunction Associated with COVID-19: a Review Article.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has had a negative impact on health, the economy, and social life throughout the world. COVID-19 pathology mainly involves the lungs. However, other organs can also be involved, including the liver, resulting in liver injury, elevated liver enzymes and reduced albumin levels. Involvement of the liver may increase the possibility of a misdiagnosis due to atypical presentations. This re-view article aimed to highlight the impact of COVID-19 on the liver, focusing on liver injury and its effect on severity and prognosis. METHODS: The author reviewed all published and in-press articles about COVID-19-associated liver injury using four electronic databases. A total of 55 articles were included in this review after removing duplicate records and establishing the necessary relevance. This review summarizes the recent studies focusing on how SARS-CoV-2 infection affects liver histology, liver enzymes, and albumin levels. RESULTS: COVID-19 is associated with varying degrees of liver injury, most notably increased levels of aspartate transaminase and alanine transaminase. Patients with severe COVID-19 are more likely to develop liver injury, elevation in the liver enzymes, and reduction in the albumin levels. In addition, COVID-19 patients with pre-existing liver injury are predisposed to develop more severe disease and have a poorer prognosis and higher mortality. Portal inflammation and focal hepatic necrosis are the most common histopathological characteristics observed among COVID-19-associated liver injury patients. The mechanisms of liver injury in COVID-19 are thought to arise from systemic inflammatory responses, hypoxia-reperfusion dysfunction, drug-induced liver injury, and/or a direct effect of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). CONCLUSIONS: Clinicians need to be alert when dealing with COVID-19 patients who have chronic liver disease, particularly when prescribing medications to avoid the risk of drug-induced liver injury. Monitoring liver enzymes and albumin levels during COVD-19 illness is essential, as it predicts disease severity and prognosis.

Hematological Parameters Predict Disease Severity and Progression in Patients with COVID-19: a Review Article.

BACKGROUND: In December 2019, an outbreak of pneumonia of no identifiable cause had been widely spreading in Wuhan, Hubei Province, China. In late December 2019, the pathogen was identified as a new strain of coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and its associated disease, named Coronavirus disease-19 (COVID-19). As of July 3, 2020, 10,906,822 cases have been confirmed worldwide, with 522,112 deaths, as reported by the World Health Organization. Given the developing situation with COVID-19, extensive studies are urgently needed that determine indicators of severity to provide evidence for health policymakers. This study aimed to review the currently available data on hematological parameters to predict disease severity in patients of COVID-19. METHODS: We performed a review using three electronic databases. Fourteen papers are included. In this review, we summarized the latest research highlighting the clinical features, pathogenesis, and diagnosis, with a concentration on hematological parameters that predict severity to help identify patients with severe disease. These indicators will help doctors know earlier which patients may need intensive care unit (ICU) care to manage their patients with an evidence-based protocol. RESULTS: Most reviewed studies report hematological parameters that predict disease severity, including lymphopenia and elevated fibrin fragment D. CONCLUSIONS: We recommend using these indicators in addition to others, like respiratory failure, shock, or multiple organs dysfunction syndrome, for disease classification in situations where there are insufficient ventilators or ICU beds to prioritize advanced medical services accordingly and to ensure the maximum provision of sufficient medical care.