Utilization of Over-the-Counter Painkillers Among Medical Students During Academic Examinations.

The utilization of over-the-counter (OTC) painkillers among medical students during academic exams has raised concerns about health risks and potential implications, including substance abuse and academic performance. This cross-sectional study aimed to estimate the prevalence of OTC painkiller utilization among medical students at Alfaisal University during academic exams. Additionally, the study explored and identified the factors that influenced the patterns of OTC painkiller utilization among these students. The study was conducted from January to May 2023, following approval from the Institutional Review Board. The research involved surveying medical students of different genders, nationalities, and academic years during examination periods. Out of 1,500 medical students, 194 participated, resulting in a response rate of approximately 13%. The study results revealed that 50.5% of medical students used OTC painkillers during exams. While there were no significant variations based on gender or nationality, the prevalence of OTC painkiller utilization varied significantly across academic years. During exam periods, the primary reason reported for using OTC painkillers was pain management. Additionally, some students mentioned using OTC painkillers to seek relaxation, improve sleep, enhance concentration, and stay alert. These insights shed light on the coping strategies practiced by students during high-stress academic periods. Most participants demonstrated familiarity with the guidelines for safe OTC painkiller utilization. Although the majority used painkillers infrequently or as needed, a subgroup reported increased utilization during exams. This finding highlights the importance of continuous monitoring and health education initiatives to prevent or address potential OTC painkiller abuse among medical students during exam periods. Ensuring the well-being of medical students is a priority, and appropriate measures should be employed to address any emerging concerns related to substance abuse. By addressing these issues proactively, educational institutions can promote a healthier academic environment during exam periods.

Privacy Concerns Over the Use of Webcams in Online Medical Education During the COVID-19 Pandemic.

The emergence of the coronavirus diseases 2019 (COVID-19) pandemic has transformed traditional classroom education to online learning worldwide. Challenges to this sudden transformation include protecting student privacy while using online medical education services. Consequently, dealing with challenges to online medical education became a heated debate at Alfaisal University. This study aimed to determine the challenges of using webcams during online classes and the ensuing implications for medical education during the COVID-19 pandemic. A cross-sectional study was conducted during the 2020-2021 academic year. The study investigators developed and validated a self-administered online questionnaire that targeted preclinical and clinical medical students at Alfaisal University, which is a private not-for-profit academic institution that was founded in 2008. Alfaisal University consists of five colleges: Medicine, Business, Engineering, Pharmacy, and Science. A total of 319 medical students completed the study questionnaire, with a response rate of 25%. The median age of the study sample was 21 years, with 63.3% females; 78.1% were in preclinical (first to third) years and 21.9% were in clinical (fourth to fifth) years. Of the respondents, 76.5% reported not using webcams when communicating via social media and 64.3% preferred blended learning, i.e., a combination of face-to-face and online learning. An overwhelming majority (91.5%) of study respondents were against using webcams in online classes for reasons including privacy (88.4%) and anxiety (64.4%). Privacy was the main concern of study respondents. Information about online privacy, including information being collected and how it will be used, should be provided to the students. Effective strategies to improve online learning experiences and protect the privacy of students should be explored.

Challenges to Online Medical Education During the COVID-19 Pandemic.

The coronavirus disease 2019 (COVID-19) pandemic has impacted all aspects of our lives, including education and the economy, as we know it. Governments have issued stay-at-home directives, and as a result, colleges and universities have been shut down across the world. Hence, online classes have become a key component in the continuity of education. The present study aimed to analyze the impact of the COVID-19 pandemic on online education at the College of Medicine (COM) of Alfaisal University in Riyadh, Saudi Arabia. Between March and April 2020, we emailed a survey to 1,289 students and faculty members of the COM. We obtained 208 responses (16.1%); 54.8% of the respondents were females, and 66.8% were medical students; 14.9% were master's students, and 18.3% were faculty. Among the respondents, 41.8% reported having little or no online teaching/learning experience before the pandemic, and 62.5% preferred blending online and face-to-face instruction. The reported challenges to online medical education during the COVID-19 pandemic included issues related to communication (59%), student assessment (57.5%), use of technology tools (56.5%), online experience (55%), pandemic-related anxiety or stress (48%), time management (35%), and technophobia (17%). Despite these challenges, most of the respondents (70.7%) believed that the COVID-19 pandemic has boosted their confidence in the effectiveness of online medical education. Consequently, 76% of participants intended to integrate the online expertise garnered during the pandemic into their practice. In short, the modern study demonstrated a largely positive impact of the COVID-19 pandemic on online medical education.

Eligibility of Medical Students to Serve as Principal Investigator: An Evidence-based Approach.

Determining the eligibility of principal investigators (PIs) is a challenging task, especially at an academic institution. The prevailing practice within the academic community is not to grant PI status to students. There is a lack of studies that have investigated students' eligibility to serve as PI. This study aimed to explore the faculty and students' perceptions of the PI eligibility of medical students. A secondary objective was to assist the university in developing an evidence-based PI eligibility policy. To achieve the study aims, the investigators developed and validated a survey that targeted both faculty and students of Alfaisal University, College of Medicine (COM). In total, 53 faculty (four were administrators), and 135 medical students responded. The response rates were approximately 50% and 12% for faculty and students, respectively. Of the faculty, 62% reported that medical students are not PI eligible without the supervision of a faculty member. Of the students, 77% reported that they were not qualified to serve as PI. The results of the current study support the practice at most universities of not allowing medical students to serve as PI.

Local Anesthesia With Monitored Anesthesia Care vs General Anesthesia in Thyroidectomy: A Randomized Study.

BACKGROUND: Early in the 20th century, thyroid surgery was performed using local anesthetic techniques. When general anesthesia became safer, surgeons started performing thyroidectomy exclusively under general anesthesia. However, recent descriptions of thyroidectomy under local anesthesia claim similar results to thyroidectomy under general anesthesia. Surgery conducted under local anesthesia can result in early discharge, ie, a hospital stay of less than 8 hours. HYPOTHESIS: Thyroidectomy can be performed under local anesthesia with monitored anesthesia care (MAC) with results similar to general anesthesia in an outpatient or inpatient surgery setting. DESIGN: A prospective randomized study comparing local anesthesia with MAC vs general anesthesia in adult patients undergoing thyroidectomy in a potential outpatient setting, defined as same-day discharge. Patients were excluded if they were not able to receive local or general anesthesia. In addition, we performed an outcome evaluation of the use of local anesthesia with MAC for thyroidectomy and the use of outpatient surgery for thyroidectomy. We compared 58 consecutive thyroidectomies performed prior to the study with 58 consecutive thyroidectomies performed after the study. SETTING: A 486-bed university-affiliated hospital. RESULTS: Fifty-eight patients undergoing thyroidectomy received random assignment: 29 to local anesthesia with MAC and 29 to general anesthesia under study protocol. Fifty-one surgical procedures (88%) were completed as outpatient surgery. No significant differences were found between the 2 study groups in demographics, postoperative adverse symptoms, complications, hospital admission, or patient satisfaction. Patients in the general anesthesia group spent, on average, more time postoperatively than patients in the group that received local anesthesia with MAC in the outpatient surgery center until same-day discharge (P = .02). When compared before the study, we found a significant increase after the randomized study in the use of local anesthesia with MAC (P<.001) and outpatient thyroidectomies (P<.001). CONCLUSIONS: Thyroidectomy can be performed in the studied patient population under either general anesthesia or local anesthesia with MAC, expecting similar operative results, clinical results, and patient satisfaction. In addition, local anesthesia with MAC can reduce the postoperative time spent in an outpatient surgery setting with potential health care cost savings.

Thromboembolic events in patients with inflammatory bowel disease.

BACKGROUND/AIMS: Inflammatory bowel disease (ulcerative colitis and Crohn's disease) is characterized by a chronic inflammatory condition, and is accompanied by abnormalities in coagulation and a hyper-coagulable state. This study was conducted to examine the risk factors for developing Thromboembolic Events in Inflammatory Bowel Disease (IBD) in a population with prevalent consanguinity. PATIENTS AND METHODS: Patients with a definitive diagnosis of IBD who were seen in the gastroenterology clinic of King Khalid University Hospital (Riyadh, Saudi Arabia) from 2010- to 2012, were asked to participate in this prospective cohort study, and were followed for one 1 year. Data was collected using specifically designed case report forms (CRF) by trained research personnel. RESULTS: A total of 100 Saudi patients with IBD were studied. There were 51 (51%) women and the mean ± standard deviation (SD) age of the group was 31.24 ± 10.78 years. Those with Crohn's disease constituted 72% of the patients, and 28% had ulcerative colitis. Eight patients (8%) had at least one Thrombotic Event ([six deep venous thrombosis (DVT), and two pulmonary embolism (PE)]. Family history of deep venous thrombosis was present in 5%, and family history of pulmonary embolism (PE) in 4% of the patients. After adjusting for age and gender, a family history of Thrombotic event was identified as to be the only statistically significant predictor of thrombosis in IBD patients (RR = 9.22, 95% CI: 2.10--40.43). CONCLUSION: In a population with high consanguinity, Thromboembolic events (DVT and PE) had a prevalence of 8% among IBD patients, positive family history of pulmonary embolism was a predictor of thrombosis. Further studies are needed to explore the role of genetic factors in this population.

Nonclinical factors associated with primary care physicians' ordering patterns of magnetic resonance imaging/computed tomography for headache.

RATIONALE AND OBJECTIVES: The purpose of ordering an imaging test for headache, which is one of the most common reasons for patient consultation with a primary care physician (PCP), include medical indications as well as patient anxiety and medico-legal concerns. The impact of nonclinical factors on PCPs' ordering patterns of magnetic resonance imaging/computed tomography for patients presenting with a headache was examined. MATERIALS AND METHODS: A retrospective record review of all patients treated for headache as their primary complaint by a PCP from a multispecialty group practice associated with an 180,000-member Health Maintenance Organization during calendar year 2000 was examined. The practice included 18 clinics. Logistic regression was used to estimate the association between physician ordering patterns of imaging tests and patient, physician, and clinic setting characteristics. RESULTS: Of the total study subjects (n = 4,372), a magnetic resonance imaging/computed tomography imaging test was ordered for 5.3%. At their first encounter, patient's gender, site of care, and insurance status under the health care system's Health Maintenance Organization had statistically significant associations with the likelihood of imaging test orders. Female physicians were less likely to order an imaging test (OR = 0.65; 95% confidence interval, 0.39-1.08). For subsequent encounters, however, site of care was the only nonclinical factor that had a consistent association with the likelihood of having a magnetic resonance imaging/computed tomography ordered. CONCLUSION: These data show that a number of nonclinical factors may have been associated with having an imaging test ordered by a PCP when patients presented with a headache. These factors were more significant when the patient was being seen for the first time with this complaint.

An effective team approach to improve postoperative hip fracture care.

OBJECTIVE: To develop an initiative using standardized discharge orders to improve the posthip fracture care of patients aged 50 years or older. DESIGN: Prospective nonrandomized study. SETTING: Hospital orthopaedic service. PARTICIPANTS: Patients at our institution older than age 50 years sustaining a hip fracture who were followed for at least 6 months and qualified for osteoporosis medication. INTERVENTION: The endocrinology and orthopaedic areas agreed to add calcium/vitamin D supplementation, a dual-energy x-ray absorptiometry scan request, and a consult with endocrinology to the hospital discharge orders. OUTCOME MEASURES: The proportions of patients using calcium or bisphosphonate before and after the intervention were compared using the McNemar test. The designated level of significance was 0.05. RESULTS: Originally, 37 of 137 patients were taking calcium/vitamin D supplements. Following this initiative, 92 of 137 were taking the supplement (P < 0.0001). Seventeen of 137 patients were taking bisphosphonate initially and 65 of 137 after the initiative (P < 0.0001). After the initiative, 100% of the discharged patients were offered calcium/vitamin D, a dual-energy x-ray absorptiometry scan, and an endocrinology appointment. All of the patients who reported for the endocrinology consult appointment were offered bisphosphonate therapy. Eighty-two patients kept the appointment for the dual-energy x-ray absorptiometry scan, and 54 saw the endocrinologist. CONCLUSION: The addition of a calcium/vitamin D supplement and an endocrinology appointment to the hospital discharge orders was an effective method of improving treatment and enhancing compliance.