Team-based learning versus interactive lecture in achieving learning outcomes and improving clinical reasoning skills: a randomized crossover study.

BACKGROUND: This study aimed to investigate the impact of interactive lecture (IL) and team-based learning (TBL) on improving clinical reasoning skills (CRSs) and achieving learning outcomes (LO). Students' feedback was obtained about the strategies. METHODS: This study was carried out at the Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia. Two modules, endocrinology, and emergency were selected. Students of each batch in both modules were divided into two arms. With a randomized crossover design, IL & TBL were used for two separate topics in each module. After each topic, a quiz in the form of well-structured MCQs was taken. A questionnaire was designed to obtain students' feedback. SPSS version 23 was used to analyse results. The difference between the mean values was calculated by Student's t-test. Feedback data is presented as frequency. P-value ≤ 0.05 was considered statistically significant. RESULTS: Learning outcomes were achieved by all groups in two modules, with both instructional strategies, IL and TBL. Students attempted >70% correct answers. However, in the emergency module, the groups with TBL as the instructional strategy performed better in quiz1 and quiz 2 (p = 0.026 and p = 0.016, respectively). Similarly, in the endocrinology module (3rd year), although the groups with TBL as the instructional strategy performed better in both quizzes, it was significant in quiz1 (p = 0.02). The difficulty indices of the clinical reasoning questions (CRQ) were used as the parameters for comparison. In the emergency module, group1, in quiz1, with TBL as an instructional strategy performed better in the CRQ (p = 0.017), while in quiz2, group2 with TBL as the instructional strategy performed better (p < 0.001). Group1 of the third-year students (endocrinology module) performed better in the CRQ in quiz 1 with TBL as an instructional strategy than group 2 with IL (p = 0.04). Mostly, students in both modules preferred TBL over IL, and especially they liked team application. Students perceived that TBL was a better strategy to learn CRS. CONCLUSIONS: Students achieved LOs and CRS better with TBL as an instructional strategy. They preferred TBL over IL. It is suggested to include TBL, or increase its percentage, in the curriculum.

Experiences of virtual teaching during COVID-19 in medical institutes of Karachi, Pakistan: teachers' perspective.

Objective: To determine the experiences of faculty members related to virtual teaching. METHODS: The cross-sectional study was conducted from January 15 to March 15, 2021, at undergraduate medical institutions located in Karachi, and comprised all the faculty members. Data was collected using a Google Survey questionnaire, and it was analysed using SPSS 20. RESULTS: Of the 385 subjects, 157(40.78%) were from basic sciences faculty, and 228(59.2%) were from the clinical sciences faculty. The majority had 3-5 years of teaching experience 142(37%). The most common online tool was Zoom 250(65%). The faculty who had prior experience or had received formal training for online teaching was more successful in controlling and engaging students than the rest (p<0.001). Those who had enough computer literacy had a better experience in conducting online teaching sessions (p=0.01). The experienced faculty found the opportunity to focus more on the topic that was to be taught online (p<0.001). CONCLUSIONS: Most of the faculty members used online tool Zoom. Faculty members with computer literacy and proper training for online teaching were more successful in controlling and engaging students and conducting online teaching sessions.

Factors disturbing undergraduate students' interaction during lectures: A university-based survey.

Objectives: To explore the factors that disturb students' interaction during lectures and interfere with their active participation. Methods: This cross-sectional study was conducted at King Abdulaziz University (KAU), Jeddah, Saudi Arabia. The study lasted approximately nine months, beginning on May 9, 2018, and ending on February 6, 2019. Students of different faculties participated in the study. A valid questionnaire was used after piloting. Four major categories were defined: classmate factors (CMFs), teacher-related factors (TRFs), personal factors (PFs), and class environment factors (CEFs). Results: A total of 658 students were included. Among all, 428 (65%) were females, and 230 (35%) were males. The comparison of main categories showed that CMFs, TRFs, PFs, and CEFs disturbed students' interaction 74%, 55%, 50%, and 84%, respectively. The comparison of the factors disturbing students' interaction showed that females were more disturbed by the CMFs (p=0.036) and CEFs (p<0.001) than males. CMFs, PFs, and CEFs disturbed more married students' than unmarried. CMF more disturbed science faculty students' interaction compared to all other groups. CEF showed less disturbance among Engineering/Math group students' interaction compared to other groups. The male gender and sixth-year students were the predictors of TRF disturbance, while the married students were the predictors of disturbance by PF. Conclusion: Several factors (PF, CMF, TRF, and CEF) disturbed students' interaction during a lecture. Additionally, the male gender, married students, and sixth-year students were the associated factors of disturbed interaction during a lecture. We suggest that teachers and educational leaders need to devise a policy to overcome these factors to provide a conducive learning environment.

Medical Students' perceptions and attitudes toward Medical Leadership and Management.

OBJECTIVES: To find out medical students' perceptions and attitudes toward medical leadership and management (MLM). METHODS: A total of 336 medical students from the 2nd to 6th academic years from King Abdulaziz University (KAU), Jeddah, Kingdom of Saudi Arabia (KSA), were included in this cross-sectional study. This study was conducted in January-February 2020. The students were asked about their perceptions, attitudes, and interests in the leadership of medical care and clinicians. A four-part questionnaire was used for collecting data. SPSS-21 was used for analysis. RESULTS: The participants included 172 (51.2%) males and 164 (48.8%) females. In total, 105 (31.3%) participants agreed that they had been very well educated about their perception, behavior, and interest in the field of medical leadership and clinic management, and 175 (52.1%) students agreed that clinicians should influence management decisions in a healthcare setting. Overall, 167 (49.7%) students agreed that management/leadership skills are important for clinicians. In total, 145 students (43.2%) desired to have more leadership training in medical school, and 129 (38.4%) students agreed to seek additional leadership/management training in their postgraduate research studies. When asked about their self-perception of good leadership skills, the students indicated that good leadership skills included integrity (47.9%), conflict resolution (46.7%), organization (44.4%), confidence (41.9%), communication (40.5%), self-reflection (40.2%), time management (33.6%), the ability to motivate others (36.9%), and the ability to keep calm under stress (33.3%). CONCLUSION: Many students were well aware of the MLM concepts. However, students agreed that management/leadership skills are important for clinicians, and there should be more leadership training in medical schools.

Correlation of Serum Vaspin, Omentin-1, and adiponectin with metabolic phenotypes in Type-2 diabetes mellitus patients.

OBJECTIVES: To investigate adipocytokines' (vaspin, omentin-1, and adiponectin) correlation with metabolic phenotypes in type 2 diabetes mellitus (T2DM) patients. METHODS: This case-control research was done at the Diabetic Clinic in Jeddah, Kingdom of Saudi Arabia (KSA), from November 2018 to March 2019. Seventy-five T2DM patients and 75 gender, age, and BMI-matched healthy subjects were recruited for this research. RESULTS: In DM patients, the concentrations of serum vaspin and omentin-1 were substantially lower (p<0.001) than in the control group. A significant positive relationship between vaspin concentration and DBP (p<0.001), BMI (p<0.001), and waist circumference (p<0.001) was found in patients and control subjects, while FPG (p<0.016), serum insulin (p<0.001), HOMA-IR (p<0.001), TC (p<0.001), TG (p<0.001), and LDLc (p<0.001) were significantly interrelated among patients. Serum concentrations of omentin-1 and ADN were significantly negatively correlated with serum insulin, HOMA-IR, and TG among the DM group. Serum vaspin and ADN levels were significantly higher in the cases and control groups with BMI>25, and no gender-wise variance was observed in adipocytokines levels. Binary logistic regression analysis showed a significantly negative predictive relationship of vaspin and omentin-1 with DM. CONCLUSION: The DM group displayed substantially lower serum vaspin and omentin-1 levels. However, there was no consistent relationship observed between these adipocytokines and metabolic phenotypes.

Depression, anxiety and stress among medical and non-medical students in Saudi Arabia: An epidemiological comparative cross-sectional study.

OBJECTIVES: To quantify the extent and variation of depression, anxiety and stress among medical and non-medical Saudi Arabian students. METHODS: In this cross-sectional study, students from Umm Al-Qura University, Makkah, Saudi Arabia, were recruited. The Faculty of Education was randomly selected to represent the non-medical colleges. The depression, anxiety and stress scale-21 items (DASS-21) was used to estimate the study outcomes. RESULTS: Of the 465 undergraduates recruited in this study, 49.68% (n=231) were medical students and 50.32% (n=234) were non-medical students. Approximately 54%, 53%, and 38% of the participants were found to be suffering from depression, anxiety, and stress, respectively. The analyses showed that the two groups did not differ significantly with respect to stress and depression (p=0.934 and 0.423, respectively). However, the non-medical students exhibited a significantly higher anxiety score compared to the medical students (p=0.002). Family conflicts was a common risk factor for the studied psychological disturbances. Female gender and travel time from home to university were significant predictors of depression and anxiety, whereas a positive history of a psychological condition increased the likelihood of depression and stress. CONCLUSION: There was a high prevalence of anxiety, stress, and depression among the students, with a significantly higher anxiety levels among the non-medical students.

Blended Learning: The impact of blackboard formative assessment on the final marks and students' perception of its effectiveness.

OBJECTIVE: To explore the impact of Blackboard (Bb) formative assessment on the final score in the endocrine module and determine the medical students' perception of the impact and effectiveness of Bb. METHODS: This exploratory case study was carried out at the King Abdulaziz University (KAU), Jeddah, Saudi Arabia (SA). Blackboard was used in the course management and formative assessment of third-year medical students and three years of data was collected (2016, 2017, 2019). In the last week of the module before the final exam, a formative assessment test that comprised of 50 Multiple Choice Questions (MCQs) was posted on Bb each year. All the students filled a questionnaire regarding their perception about the impact and effectiveness of Bb. RESULTS: Overall, summative exam scores were significantly higher than the scores in formative assessment (p <0.001). A substantial positive correlation was observed between students' marks in the online (Bb) MCQ exam and their final exam marks (p <0.001). Regarding the features of Bb, most often used by the students' were course resources uploaded on the Bb, assignments, online quizzes, and others. Majority of the students were satisfied with the use of Bb in this module. CONCLUSIONS: The majority of the students liked this blended learning (BL) method and conceded the impact and effectiveness of Bb. The formative online assessment on Bb improved the students' performance in the final exam and a positive correlation was noted between students' marks in online (Bb) exams with their final exam marks.

Coronavirus Disease 2019 (COVID-19) Pandemic and Economic Impact.

In less than two decades, the world has experienced three outbreaks of deadly Coronaviruses, including the recent pandemic of Coronavirus Disease 2019 (COVID-19) in China. COVID-19 posed an emergency of international concerns, and cases have been reported in more than 200 countries/regions that resulted in health, lives, and economic losses. China's economic growth is projected to fall to 5.6% this year, the International Monetary Fund (IMF) projected that policy investment and tax policies to implement $3.3 trillion and contributes further $4.5 trillion. IMF forecasts grow from 3.7% of global gross domestic product (GDP) in 2019 to 9.9% in 2020. GDP ratio projected from 3.0% in 2019 to grow 10.7% in 2020, the US ratio expected to increase from 5.8% to 15.7%. France, Germany, Italy, Japan, and the United Kingdom (UK) each reported public sector funding programs totalling > 10% of their yearly GDP. There is a dire need for regional and international co-operation to extend hands to prevent further spreading of COVID-19.

Association of Serum Omentin-1, Chemerin, and Leptin with Acute Myocardial Infarction and its Risk Factors.

OBJECTIVE: To determine the association of serum omentin-1, chemerin, and leptin with acute myocardial infarction (AMI) and its risk factors among individuals admitted with AMI to the coronary care unit (CCU). METHODS: The current case-control study was conducted at the CCU of King Abdulaziz University Hospital (KAUH), Jeddah, Kingdom of Saudi Arabia (KSA), in 2016-2018. A total of 122 AMI patients admitted to CCU, and 52 BMI and age-matched healthy subjects, between 30 and 65 years of age, were included. RESULTS: Chemerin and omentin-1 are independent predictors of the incidence of MI. Furthermore, serum omentin-1 was significantly lowered while chemerin and hsCRP levels were found to be significantly raised among the individuals with AMI compared to the healthy subjects, and no notable change was found in the serum leptin level. Serum omentin-1, chemerin, and leptin were significantly correlated with weight, BMI, waist circumference in patients, and control subjects. Binary logistic regression analysis displayed that the occurrence of MI is positively correlated with fasting plasma glucose (FPG), TC, TG, LDL-C, hsCRP, and chemerin and in a negative manner with HDL-C, and omentin. The chemerin and omentin-1 were also linked with the MI in multiple logistic regression analysis. CONCLUSIONS: The present results indicated that the serum omentin levels were significantly lowered while chemerin and hsCRP levels were found to be markedly raised among patients. No change was found in serum leptin levels. Serum chemerin and omentin-1 levels were independently associated with the MI. It appears that these parameters may be used to assess the risk spectrum of CAD.

Association of serum osteoprotegerin with severity of chronic liver disease in female patients: A potential biomarker.

OBJECTIVE: To determine the association of serum osteoprotegerin (OPG) with the severity of chronic liver disease in female patients. METHODS: This case-control study was conducted in Madina Teaching Hospital from 2019-2020.An institutional review board of University Medical and Dental College, The University of Faisalabad gave the approval to conduct the study. Only female patients of age group 40 to 60 years having CLD were included in this study. Total 80 participants were enrolled after fulfilling the inclusion and exclusion criteria. Serum OPG levels were measured by enzyme linked immunosorbant assay (ELISA) supplied by ELAB Sciences, USA. The severity of disease was assessed by Child-Pugh classification. RESULTS: OPG levels were significantly different between the three Child-Pugh classes. OPG levels were significantly high in class C indicating increased level of this cytokine in CLD as compared to class A (p = <0.05). There was a positive association of OPG with splenomegaly (OR = 2.10, p = <0.001), hepatomegaly (OR = 4.41, (p = <0.05), skin pigmentation (OR = 2.06, p = <0.05), malena (OR = 1.87, p = <0.05) and prolonged bleeding (OR = 1.86, p = <0.05). CONCLUSION: The levels of serum Osteoprotegerin is increased in severe form of chronic liver disease (Class C) of Child-Pughs classification as compared to mild (Class A) and moderate (Class B) forms of Child-Pughs classification.

Association between leptin, obesity, hormonal interplay and male infertility.

Male infertility is a major health problem worldwide. We investigated a possible association between leptin, obesity, hormonal interplay and male infertility. This cross-sectional study of 313 males (178 infertile and 135 fertile) was carried out in 2017. The subjects were categorised by body mass index (BMI) and body fat percentage (BF%) into normal weight, overweight and obese. Significantly higher levels of BMI and BF% (p-value < 0.001) and lower levels of FSH, LH, testosterone, and SHBG (p-value < 0.001) were found in infertile males. However, no significant difference was observed in leptin levels (p-value = 0.35). Leptin levels were significantly higher, and all the sex hormones were significantly lower (p-value < 0.001) in obese subjects, whereas according to BF% only leptin, FSH and SHBG were significantly different. Leptin showed a significant positive correlation with BMI and BF% (p < 0.001). A strong positive link to serum testosterone was found with age, FSH, and LH (p < 0.001) and a negative one with BMI and BF% (p < 0.001). In mutivariable anlaysis, after adjusting for the other covariates, a significant association between FSH and testosterone (p-value <0.001) was found. Serum leptin levels did not differ significantly in fertile and infertile groups, and no association was found with infertility. Furthermore, male obesity was found to be associated with infertility with the decrease in levels of sex hormones.

Frequency and perceived causes of depression, anxiety and stress among medical students of a private medical institute in Karachi: a mixed method study.

OBJECTIVE: To determine medical students' level of mental distress, assess their perceptions of its causes, and to gather their suggestions for possible solutions.. METHODS: The mixed-method qualitative-quantitative study was conducted at Liaquat National Medical College, Karachi, from August 2016 to March 2017, and comprised medical students across years 1 to 5. In phase one, the depression, anxiety and stress scale-21 questionnaire was administered to explore prevalence rates among the subjects. In phase two, focus group discussions were carried out to explore the possible reasons for the students' mental distress. Data was analysed using SPSS 20. RESULTS: Of the 270 students approached, 188(70%) returned the completed questionnaire. The overall mean age of subjects was 21.4}2.2 years (range: 18-25 years). There were 100(53%) females, and 88(47%) males. The prevalence of depression was 134(71%), anxiety 136(72%) and stress 66(35%). Major concerns mentioned by the students in phase two related to academic issues. Students in the focus group also complained of poor lifestyles, financial constraints, lack of support services for stress management, and lack of physical and recreational facilities. Students suggested that their mental distress might be alleviated by curricular innovations such as reducing the number and duration of lectures, increasing small group activities, and pre-scheduling exams. Students also strongly requested proper support services at the institutional level. CONCLUSIONS: There was high mental distress among medical students and it was mainly related to academic pressure.

Assessing reliability and validity of Revised Biggs Two-Factor study process questionnaire to measure learning approaches among undergraduate medical students in Lahore, Pakistan.

OBJECTIVE: To assess reliability and validity of Revised Biggs Two-Factor Study Process Questionnaire to measure Learning approaches among medical students. METHODS: The cross-sectional study was conducted at Shaikh Zayed Medical College, Lahore, Pakistan, from November 15, 2014, to January 15, 2015. The 20-item Revised Biggs Two-Factor Study Process Questionnaire was used to assess medical students enrolled from the first to the final year of their studies. Data was analysed using SPSS 20. The reliability of the questionnaire was assessed by Cronbach's alpha, and confirmatory factor analysis was done to confirm the factor model. RESULTS: Of the 480 students approached, 284(59.2%) completed the questionnaire. Cronbach's alpha value was found acceptable at 0.79 and 0.72 for the deep approach and surface approach scales respectively. Comparative Fit Index value (0.858) confirmed a good fit for the model. CONCLUSIONS: Revised Biggs Two-Factor Study Process Questionnaire was found to be a reliable and valid instrument to measure learning approaches among medical students.

Status of bone health and association of socio-demographic characteristics with Bone Mineral Density in Pakistani Females.

BACKGROUND & OBJECTIVE: The "silent thief" of bone osteoporosis is associated with various modifiable factors, identifying these factors is important in decreasing the prevalence of this highly prevalent disease. Therefore, this study was planned to identify these risk factors for osteoporosis in premenopausal and postmenopausal Pakistani women. METHODS: A total of 1205 pre and postmenopausal females between the ages of 20 to 80 years were selected. Detailed history about the socio-demographic characteristics including age, education, profession, marital and resident status was recorded. Medical and gynecological history was also taken after informed consent Bone health of females was assessed using calcaneal ultrasound bone densitometer. SPSS 22.0 was used to analyze data. RESULTS: Univariate analysis showed that age (30-39 yrs, and 60-69 yrs), occupation (housewives) and education (secondary and primary education, illiterate) were significantly associated with low bone mass density (LBMD). Multivariate analysis showed that age 30-39 years (OR=0.25 95%CI 0.13 - 0.49), age 40-49 years (OR=0.30 95%CI 0.15 - 0.59), age 50-59 years (OR=0.42 95%CI 0.22 - 0.79), primary education (OR=3.83, 95%CI 2.30 - 6.38) and illiteracy (OR=3.83 95%CI 2.52 - 5.82), were significantly associated with LBMD. The prevalence of osteopenia and osteoporosis was 29.8%, 27.2%, respectively, while 43% subjects had normal BMD. CONCLUSION: It is concluded that, within Pakistani population, the prevalence of osteopenia is high even at an early age group and the odds of having LBMD are more in less educated or illiterate women.

Prevalence and Associated Risk Factors of Gestational Diabetes Mellitus at a University Hospital in Saudi Arabia.

OBJECTIVES: We aimed to find out the prevalence and associated risk factors of GDM among females who attended antenatal clinic at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia (SA). METHODS: This retrospective study was carried out from 25th September 2016 till 20th December 2016, at the Endocrine Clinic, Faculty of Medicine, KAUH, Jeddah, SA. A total of 5000 women attended antenatal clinic and 637 women were referred to the endocrine clinic for GDM. The data of only 103 GDM was included in the study because only these patients' complete data was available. The electronic record of 93 pregnant age and BMI matched females, not having GDM were selected as a control group. RESULTS: The prevalence of GDM was 12.75% (637/5000). Parity was associated with GDM (X2=16.82, P=.001) and GDM was significantly higher in multigravida while no association of GDM was found with working status, place of living, hypertension, family history of DM and BMI. Logistic regression analysis revealed that grand multigravida female had the lower risk of GDM as compared to multi, primi and nulligravida while age, working status, place of living, hypertension, family history of DM and BMI were not found significant risk factors for GDM. In GDM group, according to nationality, 68(66%) women were Saudi while 35(34%) were expatriates' (Yemeni 11.2%, Egyptians 3.9%, Indians 3.9%, Pakistanis 2.9%, Sudanese 2.9%, Syrians 2.9% and others). CONCLUSIONS: The prevalence of GDM was 12.75% and it was not associated with working status, place of living, hypertension, family history of diabetes and BMI.

Perceived stress, reasons for and sources of stress among medical students at Rabigh Medical College, King Abdulaziz University, Jeddah, Saudi Arabia.

BACKGROUND: Medical students have high levels of stress that could be due to the daily life stressors and the extra stress of academic burden. The present study investigated the perceived stress level as well as the reasons and sources of stress among medical students at a comparatively newly established medical college affiliated with King Abdulaziz University (KAU), Jeddah, Saudi Arabia (SA). METHODS: The present study was carried out at Rabigh Medical College (RMC), KAU, Jeddah, and completed in 2015. The data was collected by an anonymous self-administered questionnaire that has three components: a list of 33 items of probable stressors, perceived stress scale, and demographic information and academics. RESULTS: The response rate in our study was 86% (152/176), the mean age was 20.35 ± 1.09, 77 (51%) were from preclinical years and 75 (49%) from clinical years. The mean PSS score among our participants was 28.5 ± 3.8 with a median of 28.0 (IQR 26.0-31.0) and 59.2% of participants were stressed. The mean PSS score 30.6 ± 4.4 for students with sibling > 5 was significantly higher as compared to the mean PSS score (27.9 ± 3.3) for students with sibling ≤5. Similarly, the mean PSS score (32.0 ± 3.4) of students with often/always occurrence of psychosocial stressors was higher as compared to the mean PSS score (28.3 ± 3.7) of those students with less than a frequent occurrence of stressors. Moreover, those students that were more stressed had lower marks in the last exam (< 80%) as compared to students with less stress who had higher marks (≥80%) (P < .05). Performance in practicals, examinations frequency, disappointment with the class lectures, lack of personal interest in medicine, lengthy academic curriculum/syllabus, worries about the future and periodic examinations performance were rated as severe. The logistic regression analysis showed that stress cases were linked with last exam marks [OR 1.26, 95% CI 0.64-2.48], number of siblings [OR 2.27, 95% CI 0.97-5.27], and academic stressor [OR 2.02, 95% CI 0.61-6.66] but no significant relationship was found. CONCLUSION: There were high-stress levels among the participants of this study, and the main stressors were academic-related.

Prevalence and factors associated with smartphone addiction among medical students at King Abdulaziz University, Jeddah.

OBJECTIVE: To investigate smartphone addiction among medical students and to determine factors associated with smartphone addiction among sixth-year medical students at King Abdulaziz University, Jeddah. METHODS: This cross-sectional study was conducted on 203 sixth-year medical students at the Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia, during July 2017. Data analysis was done using SPSS-20. RESULTS: The number of completed questionnaires received was181 out of 203, making a response rate of 89%. There were 87 male respondents (48.1%) and 94 female respondents (51.9%). The overall prevalence of smartphone addiction was 66 (36.5%). There is a statistically significant relationship between daily hours of smartphone usage and smartphone addiction (p<0.02). Out of 66 addicted students, 24 (55.8%) students reported using their smartphone more than five hours daily, 17(34.7%) students were using it 4 to 5 hours daily, 13 (27.7%) students were using it 2 to 3 hours daily and 12(28.6%) students were using it less than two hours daily. The study showed no statistically significant relationship between smartphone addiction and smoking statusor degree of obesity. There was a significant association between the total score on the smartphone addiction scale and daily usage hours (p-value<0.005). CONCLUSION: The overall prevalence of smartphone addiction was high among our study participants. The smartphone addiction was associated with daily hours of smartphone usage.

Association of serum leptin with bone mineral density in postmenopausal osteoporotic females.

OBJECTIVE: Present study was designed to find out whether leptin is a predictor of bone mass density (BMD) in premenopausal women (PMW) and postmenopausal osteoporotic women (PMOPW) or it has no association with BMD. METHODS: One hundred and ninety two women (98 PMOPW and 94 PMW) were recruited for this study. The control group was BMI matched with osteoporotic subjects. BMD assessment was done on calcaneus by peripheral ultrasound bone densitometry and T scores were determined. Serum leptin levels were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS: Serum leptin and BMD values were significantly different in both groups (leptin, 18.56 ± 8.65 ng/ml versus 21.64 ± 9.80 ng/ml, p = 0.02) and (BMD, -0.70 ± 0.19 versus -3.17 ± 0.59, p = 0.000), respectively. In PMOPW serum leptin and BMD were considerably correlated with weight (lep, r = 0.53, p = <0.001; BMD, r = -0.21, p = 0.02), BMI (lep, r = 0.52, p = <0.001; BMD, r = -0.27, p = 0.005), waist circumference (lep, r = 0.61, p = <0.001; BMD, r = 0.18, p = 0.04), hip circumference (lep, r = 0.58, p = <0.001). Multivariate linear stepwise regression analysis showed that weight and BMI in PMW and PMOPW were independent predictors of BMD. Serum leptin level was not found to be the predictor of BMD in both groups. CONCLUSION: The present results indicate that body weight and BMI have an impact on BMD while serum leptin is not associated with BMD in PMW and PMOPW.

A comparison between wellness awareness among medical students.

OBJECTIVE: To assess and compare the dimensions of spiritual wellness as elements of quality care in medical students of private and public medical universities. METHODS: The cross-sectional study was carried out at private and public medical universities in Karachi from November 2013 to January 2015.Students from both genders and all ethnic groups19-23 years of age were included. The responses of spiritual wellness were obtained and evaluated on a four-point Likert's scale; score ranging from 0-3. Data was analysed using Predictive Analysis Software version 18. RESULTS: Out of 736 students, 286 (38.9%) were from public medical universities and 450 (61.1%) were from private-sector institutions. Students of both types of universities were aware of the concept of spiritual wellness but the level of awareness needed scaling up. Public-sector students had a stronger will, were more physically and mentally alert, more compassionate, empathetic and enthusiastic about their relationship with patients than their private-sector counterparts (p<0.05). They used spiritual wellness as a coping strategy to deal with difficult situations through religious activities. Though attentive listening was a predominant feature in both groups, the use of communication skills required particular attention to improve the element of compassionate care. CONCLUSIONS: Empowerment of spiritual wellness is more likely to enable medical students to be more compassionate towards their patients and strengthen doctor-patient relationship.

Awareness and attitudes towards organ donation among medical students at King Abdulaziz University, Jeddah, Saudi Arabia.

OBJECTIVE: To assess awareness and attitude of medical students about organ donation. METHODS: This cross-sectional study was conducted in 2014 at King Abdulaziz University, Jeddah, Saudi Arabia, and comprised medical students. The participants were asked about their religious and other beliefs towards organ donation, their reasons for not donating organs, and their personal opinions about organ donation through a questionnaire. SPSS 21 was used for data analysis. RESULTS: Of the 481 participants, 250(52%) were females, and 231(48%) were males. The overall mean age was 21.36±1.63 years. Besides, 437(90.9%) students knew what organ donation means, 433(90%) supported organ donation, and 90(18.7%) knew someone who had donated an organ. Moreover, 245(50.9%) participants were willing to donate their organ to their family alone, 198(41.2%) were willing to donate to any deserving patient while 439(91.3%) rejected that religion precluded organ donation, and 354(73.6%) did not know about the grafting of organs from a man to a woman and vice versa. CONCLUSIONS: Awareness and attitude towards organ donation were not up to the mark among the participants.