Promising score for teaching and learning environment: an experience of a fledgling medical college in Saudi Arabia.

BACKGROUND: Professional competency of graduates of an institute reflects its teaching and learning environment (TLE). This study aimed to provide a preliminary assessment of the TLE at the College of Medicine at Majmaah University. METHODS: A cross-sectional survey was conducted during the 2019-20 academic year among students at the College. A validated scoring tool "the Experience of Teaching and Learning Questionnaire" (available at https://bit.ly/3sVBuEw ) was used. The mean score of each section and statement, the difference between the mean scores of different demographic groups, and correlations between sections were analysed. RESULTS: A total of 234 (72.2%) enrolled students participated in this survey, with a male-to-female ratio and a ratio of participants from basic to clinical years being 2:1 and 1:1, respectively. Most participants reported a GPA of above 3/5. The overall mean score was 3.52/5 points. Section one "approaches to learning and studying" has the highest mean score (3.68), and no section scored a mean below three, though section three "demands made by the course" scored a borderline mean of 3.08. Students in clinical years had a significantly higher overall mean score compared to their counterparts (3.66 vs. 3.39, p < 0.001). CONCLUSIONS: Students at the College had a positive perception of the TLE, but face challenges in coping with the demands of acquiring knowledge and subject-based skills, and in appreciating the TLE especially during basic science years, highlighting the need for an atmosphere that allows them to meet demands and develop greater appreciation.

A New Generator of Probability Models: The Exponentiated Sine-G Family for Lifetime Studies.

In this article, we propose the exponentiated sine-generated family of distributions. Some important properties are demonstrated, such as the series representation of the probability density function, quantile function, moments, stress-strength reliability, and Rényi entropy. A particular member, called the exponentiated sine Weibull distribution, is highlighted; we analyze its skewness and kurtosis, moments, quantile function, residual mean and reversed mean residual life functions, order statistics, and extreme value distributions. Maximum likelihood estimation and Bayes estimation under the square error loss function are considered. Simulation studies are used to assess the techniques, and their performance gives satisfactory results as discussed by the mean square error, confidence intervals, and coverage probabilities of the estimates. The stress-strength reliability parameter of the exponentiated sine Weibull model is derived and estimated by the maximum likelihood estimation method. Also, nonparametric bootstrap techniques are used to approximate the confidence interval of the reliability parameter. A simulation is conducted to examine the mean square error, standard deviations, confidence intervals, and coverage probabilities of the reliability parameter. Finally, three real applications of the exponentiated sine Weibull model are provided. One of them considers stress-strength data.

Prevalence of Prediabetes and Type-2 Diabetes Mellitus in Cricket Players: Multi-Cricket Clubs Cross Sectional Study.

BACKGROUND & OBJECTIVES: Sports activities are highly beneficial for improving the human health and reducing the risk of diseases. This cross sectional study aimed to investigate the prevalence of prediabetes and Type-2 diabetes mellitus in cricket players compared to population based non-elite athlete control subjects. METHODS: The present matched cross sectional study was conducted in the Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia during the period October 2019 to February 2020. Initially, 700 volunteer males, (300) cricket players and (400) population based non-elite athlete control subjects were interviewed. After socio-demographic and medical history, (200) nonsmoker cricket players and (300) nonsmoker control subjects were recruited. The age of cricket players was 34 (32-37) years, weight 81 (76-84) kg, height 1.79 (1.74-1.84) meters, and body mass index (BMI) was 25.09 (23.66-26.76) kg/m2. The cricket players have been playing cricket for 4 (3-4) hours per day; 3.50 (3-4) days per week; for the total period of 24 (12-36) months. American Diabetes Association (ADA) based criteria on Glycated Hemoglobin (HbA1c) was used to investigate the prediabetes and Type-2 diabetes mellitus. RESULTS: In cricket players, the prevalence of prediabetes was 23 (11.5%) and Type-2 diabetes mellitus (T2DM) was 7 (3.5%) compared to population based matched non-elite athlete control subjects the prediabetes was 73 (24.34%) and T2DM was 63 (21.1%) (p=0.001). Among cricket players, there was a 6-folds decrease in T2DM compared to control subjects. CONCLUSIONS: The cricket sports activities decrease the prevalence of prediabetes and Type-2 diabetes mellitus (T2DM) among the cricket players compared to population based matched non-elite athlete control subjects. The study findings demonstrate the urgent need for promoting sports activities, more cricket grounds as a physiological preventive strategy against the global growing diabetes epidemic.

Efficacy of newer modalities in the management of indirect hyperbilirubinaemia at a secondary care hospital: A prospective study from 2015-2018.

OBJECTIVE: To evaluate the efficacy of current practices and new modalities for the management of neonatal indirect hyperbilirubinaemia. METHODS: The prospective study was conducted at King Khalid Hospital, Al Majmaah, Saudi Arabia, from September 2015 to September 2018, and copmprised neonates with hyperbilirubinaemia who were managed using the National Institute for Health and Clinical Excellence 2010 guidelines. The outcomes were measured in terms of decrease in total serum bilirubin and clinical improvement. Data was analysed using SPSS 25. RESULTS: Of the 233 subjects, there were 119(51%) girls and 114(49%) boys. Phototherapy was used in 162(69.5%) cases, intensive phototherapy in 36(15.5%) and intravenous immunoglobulin in 35(15%). Exchange transfusion was done in 2(0.85%) patients. All the 233(100%) patients improved with the management and total serum bilirubin significantly reduced (p<0.05). CONCLUSIONS: Newer techniques were found to have a vital role in the management of neonatal hyperbilirubinaemia.

Use of electronic health records among Saudi and Non - Saudi health providers - a comparative study at a secondary hospital, Saudi Arabia.

OBJECTIVE: Electronic Health Record (EHR) system is now considered the backbone of effective storage and retrieval of patient records in a healthcare setup. This study is an attempt to assess the knowledge, attitude and practice of healthcare professionals in the use of Electronic Health Record system in patient care. METHODS: It was a comparative cross-sectional study, conducted among the clinicians working in King Khaled Hospital, Almajmaah, Saudi Arabia. The data was collected from 260 clinicians using systematic random sampling technique. A pre-validated questionnaire was used to gather the data. Nineteen items were graded based on the adaptability, usability and knowledge of the participants. The total duration of the study from conception to completion was 6 months. RESULTS: There were 146 (56.2%) Saudis and 114 (43.8%) non - Saudi participants. Knowledge of computer was slightly more among Saudis 134 (51.5%) than non - Saudis 104 (40.0%) (p>0.05). Saudis had an overall positive attitude toward using the EHR as compared to non-Saudis (p<0.001).Frequency of accessing computers daily was more among Non-Saudi practitioners 93 (35.8%) as compared to the Saudis 85 (32.7%) which was statistically significant (p<0.001). CONCLUSIONS: This study has attempted to correlate that clinician's adaptability with an electronic record system that requires prior expertise in the use of computers. It recommends further foray into researching barriers associated with slow uptake and positive attitudinal change among clinicians using the electronic health records system in healthcare facilities across Saudi Arabia.

Dietary Attitude of Adults with Type 2 Diabetes Mellitus in the Kingdom of Saudi Arabia:A Cross-sectional study.

Background and Objectives: There is a paucity of literature on the dietary attitude (DA) of patients with type 2 diabetes in the Kingdom of Saudi Arabia (KSA). Although the prevalence of diabetes mellitus (DM) is high in Gulf countries, there remains a lack of understanding of the importance of dietary behavior in diabetes management among patients. Understanding the behavior of patients with diabetes towards the disease requires knowledge of their DA. Therefore, this study aimed to assess and evaluate the DA of type 2 diabetes patients, and it is the first of its kind in the KSA. Material and Methods: An analytical cross-sectional study was conducted among 350 patients with type 2 diabetes. A self-administered DA questionnaire was used to collect the data. Psychometric properties of the questionnaire were assessed by face validity, content validity, exploratory factor analysis, and internal consistency reliability. The data were collected using a systematic random sampling technique. Results: The overall DA of the patients was inappropriate (p = 0.014). Patients had an inappropriate DA towards food selection (p = 0.003), healthy choices(p = 0.005), food restraint (p < 0.001), health impact (p < 0.001), and food categorization (p = 0.033). A poor DA was also observed in relation to the consumption of red meat(p < 0.001), rice (p < 0.001), soup and sauces (p = 0.040), dairy products (p = 0.015), and junk food(p < 0.001). Conclusions: It is highly recommended that patients with diabetes receive counseling with an empowerment approach, as this can bring about changes in their dietary behavior, which is deeply rooted in their daily routine. Healthcare providers should also be well-informed about patients' attitudes and beliefs towards diabetes to design tailored educational and salutary programs for this specific community. Diabetes self-management educational programs should also be provided on a regular basis with a special emphasis on diet and its related components.

Knowledge, attitude, and practice (KAP) of food hygiene among schools students' in Majmaah city, Saudi Arabia.

OBJECTIVE: To determine the level of knowledge, attitude, and practice of food hygiene among primary, intermediate and high school students and explore association, if any, with socio-demographic differences. METHODS: The observational cross-sectional study was conducted at boy's schools in Majmaah, Kingdom of Saudi Arabia, from February to May 2014. Data was collected using stratified random sampling technique from students aged 8-25 year. Two schools from each level (primary, intermediate and high school) were randomly selected and data was collected from the selected schools using simple random sampling method. A self-administered modified Sharif and Al-Malki questionnaire for knowledge, attitude and practice of food hygiene was used with Arabic translation. RESULTS: The mean age of 377 male students in the study was 14.53±2.647 years. Knowledge levels was less in primary school students compared to high school students (p=0.026). Attitude level was high in primary school students compared to intermediate school students (p< 0.001). No significant difference was observed between groups with regard to practice levels (p=0.152). CONCLUSIONS: The students exhibited good practice levels, despite fair knowledge and attitude levels.

Frequency of using non-prescribed medication in Majmaah city, Saudi Arabia -- A cross sectional study.

OBJECTIVE: To determine the frequency of using non-prescribed medication in a Saudi Arabian city. METHODS: The cross-sectional study was conducted in Majmaah city, Saudi Arabia, from January to May 2014, and comprised adults of either gender. For data collection, a questionnaire was designed and its reliability was checked by Cronbach Alpha. SPSS 20 was used for statistical analysis. RESULTS: Of the 390 respondents 276(70.8%) were males, while 114(29.2%) were females. The overall mean age was 29.90±11.56 years (range: 18-83 years). Of the total, 363(93.1%) were using non-prescribed medication; and 148(37.9%) said they were using the drugs as they had experienced similar symptoms before and they knew the treatment. Public pharmacies were the main source for obtaining non-prescribed medication for 163(41.8%) subjects. Gender and use of non-prescribed medication was significantly associated (p<0.05). CONCLUSIONS: The frequency of using non-prescribed medication in Majmaah city was high. Pain-killers, antibiotics and antipyretics were the most used non-prescribed medications. Male respondents used non-prescribed medication more than the females.

Unknotting tech neck by breaking the cycle of pain and disability: Comparing the impact of instrument assisted soft tissue mobilization on specific muscles and superficial back arm line.

BACKGROUND: Computer professionals often develop a forward head posture due to prolonged hours of computer use, leading to neck pain. Instrument-assisted soft tissue mobilization (IASTM), an advanced technique for treating myofascial trigger points, has become increasingly popular for addressing these musculoskeletal issues. OBJECTIVES: The study aimed to compare the effectiveness of IASTM mobilization on SBAL (superficial back arm line) and SM(specific muscles-upper trapezius, levator scapulae, and sternocleidomastoid) in managing chronic neck pain among computer professionals. PARTICIPANTS & METHODS: The study involved 62 computer professionals, randomly divided into two groups. Group A received IASTM on SBAL and group B received IASTM on SM for neck pain each receiving three sessions weekly for four weeks. Outcome variables like Neck Disability Index (NDI), NPRS(Neck Pain Rating Scale), Craniovertebral angle (CVA), and range of motion (ROM) for flexion, and side flexion (right & left side) were evaluated at baseline, 2 weeks and 4 weeks. RESULTS: Significant improvement in NPRS were observed in both the SBAL and SM groups after 2 weeks of IASTM, wth the SBAL group demonstrating greater improvement. At 4 weeks, IASTM on SBAL showed significantly higher improvements in NPRS, CVA, NDI, and flexion compared to the SM group. The repeated measures ANOVA indicated a significant main effect of both time and group, along with a significant interaction between time and group for all outcome variables, except for CVA. CONCLUSION: The study indicates that IASTM on SBAL may offer a more effective treatment for chronic neck pain in computer professionals compared to targeting specific muscles.

The Intersection of Faith and Neurodiversity: Unraveling Religiosity in Autistic Adolescents-A Critical Review Analysis.

This literature review aims to explore religiosity, faith, and related beliefs in autistic adolescents. The term religiosity was used interchangeably with various related concepts such as faith, spirituality, and religious beliefs, and a broader, multifaceted approach encompassing the cognitive, subjective, social, cultural, and emotional domains of religiosity is analyzed in this population subgroup. In alignment with the neurodiversity paradigm, this review endeavors to adopt an inclusive lens toward autism spectrum conditions, appreciating the spectrum of cognitive and behavioral differences and highlighting the importance of recognizing strengths and challenges alike, reflecting the nuanced discourse surrounding neurodiversity and autism spectrum conditions. However, terms such as "high-functioning autism" and "disorder" were used where needed to reflect the journals included in the review. A systematic search was conducted by accessing academic search engines such as APA PsycInfo, APA PsycArticles, APA PsycTests, and PubMed. Only peer-reviewed articles written in English and performed on human subjects were included using strict inclusion and exclusion criteria. Several recurring themes were identified from the 13 articles selected after review for relevance and quality. The most important finding was the association of different terminologies and features while exploring "religiosity in autism." Thirty-nine key themes were identified, which were grouped into six major themes. These were religious faith, spirituality, and its expression in autistic adolescents; religious behaviors and practices of autistic adolescents; cognition and religion in autistic teens; social and cultural influences on religiosity in autistic young ones; parents' and carers' influence, perspectives, and experiences about faith and spirituality on autistic adolescents; and perceived benefits of faith to autistic teens: parents and adolescent perspectives. Looking at the concept of religiosity and spirituality as a whole, it can be inferred from the available research included in this review that religiosity (cognitive abilities, behaviors, and experiences) in a subset of autistic adolescents (high-functioning autism) might not be significantly subdued as compared to neurotypical adolescents. However, there is not enough research to conclude the same or the opposite for autistic adolescents in general. When found, reserved religiosity could be attributed to a plethora of factors, and decreased mental ability or mentalization, empathy, or imagination did not seem to be the sole or primary predictors or contributors to religiosity. The role of culture, parents, carers, and religious affiliations was significant and might be a stronger contributor to religiosity and its expression than other previously argued predictors like mentalization. Many autistic teens and their carers regard religiosity and spirituality as essential domains in their and their children's lives, want their children to be given opportunities to be a part of religious groups and affiliations, and look forward to government, religious, and healthcare authorities actively supporting them in this domain. The findings call for policymakers, religious leaders, and stakeholders to devise strategies for inclusion and support for autistic adolescents. The possible role of religion as a resource and coping strategy for these children and their families is worth exploring.

Artificial Intelligence Readiness, Perceptions, and Educational Needs Among Dental Students: A Cross-Sectional Study.

OBJECTIVES: With Artificial Intelligence (AI) profoundly affecting education, ensuring that students in health disciplines are ready to embrace AI is essential for their future workforce integration. This study aims to explore dental students' readiness to use AI, perceptions about AI in health education and healthcare, and their AI-related educational needs. MATERIAL AND METHODS: A cross-sectional survey was conducted among dental students at the College of Dental Medicine, Qatar University. The survey assessed readiness for AI using the Medical Artificial Intelligence Readiness Scale (MAIRS). Students' perceptions of AI in healthcare and health education and their educational needs were also explored. RESULTS: A total of 94 students responded to the survey. AI readiness scores were average (3.3 ± 0.64 out of 5); while participants appeared more ready for the vision and ethics domains of MAIRS, they showed less readiness regarding cognition and ability. Participants scored average on AI perceptions (3.35 ± 0.45 out of 5), with concerns regarding AI risks and disadvantages. They expressed a high need for knowledge and skills related to AI use in healthcare (84%), AI for health-related research (81.9%), and AI in radiology and imaging procedures (79.8%). Student readiness had a significant correlation with AI perceptions and perceived level of AI knowledge. CONCLUSIONS: This is the first study in Qatar exploring dental students' AI readiness, perceptions, and educational needs regarding AI applications in education and healthcare. The perceived AI knowledge gaps could inform future curricular AI integration. Advancing AI skills and deepening AI comprehension can empower future dental professionals through anticipated advances in the AI-driven healthcare landscape.

Smartphone Thermal Imaging for Preoperative Perforator Mapping in Perforator Based Flaps.

OBJECTIVE: To determine the diagnostic accuracy of smartphone thermal imaging for preoperative perforator mapping in perforator-based flaps, taking visual inspection as gold standard. METHODOLOGY: It was a cross-validation study conducted at the Department of Plastic Surgery, Dr. Ruth K. Pfau Civil Hospital, Karachi, Pakistan, from August 2022 to January 2023. All adult patients aged 18 to 40 years of either gender undergoing perforator flap surgery were included. Each patient followed the same treatment regimen, which involved the preoperative identification of the perforator location using the FLIR One camera. Subsequently, confirmation was achieved during the surgical procedure through visual inspection. A two-by two table was used to calculate sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy. RESULTS: The mean age of the patients was 30.10±6.87 years, ranging from 18 to 40 years. Most of the patients were males (58.7%), and 41.3% were females. Almost 80.4% were pedicle flaps, and 19.6% were free flaps. The accuracy of thermal imaging was found to be 83.2%, with a sensitivity of 84.3%, a specificity of 80%, a PPV of 92.9%, and a NPV of 62.2%, respectively. CONCLUSION: Smartphone-based thermal imaging is useful for the diagnosis of perforators and has high sensitivity and specificity.

Challenges University Students Face while Studying away from Hometown: A Cross-Sectional Study.

This study aims to highlight the challenges that undergraduates face when traveling a significant distance from home to study. These challenges are psychological, financial, and nutritional. The study was descriptive and based on a survey conducted to investigate the challenges faced by university students while studying away from their hometown. A questionnaire was used to collect data from 214 undergraduates between February and April 2021. The collected data were analyzed using the computer program SPSS version 24. Pearson's Chi-square and Fisher's exact tests were applied to observe associations between qualitative variables. A total of 214 undergraduates participated in the study, with a median age of 22 years. The study found significant relationships between weight change and housing (P < 0.001), weight change and distance (P < 0.001), level of homesickness and housing (P < 0.001), level of homesickness and college distance (P < 0.001), and financial status with housing (P = 0.025). The study revealed that a significant number of undergraduate participants face psychological, financial, and nutritional challenges. These challenges include psychosocial issues, such as homesickness financial difficulties, such as money issues, and nutritional concerns, such as weight changes.

Nrf-2-dependent antioxidant and anti-inflammatory effects underlie the protective effect of esculeoside A against retinal damage in streptozotocin-induced diabetic rats.

Esculeoside A (ESA) is a tomato-derived glycoside with antioxidant and anti-inflammatory properties. The protective effect of ESA against diabetic retinopathy is not well-investigated and was the core objective of this study. In addition, we tested if such protection involves the activation of Nrf2 signaling. Type 1 diabetes mellitus (T1DM) was induced in adult Wistar male rats by an intraperitoneal injection of streptozotocin (65 mg/kg). Non-diabetic and T1DM rats were divided into two subgroup groups given either the vehicle or ESA (100 mg)/kg. An additional T1DM group was given ESA (100 mg/kg) and an Nrf2 inhibitor (2 mg/kg) (n=8 rats/group). Treatments continued for 12 weeks. In this study, according to the histological features, ESA improved the structure of ganglionic cells and increased the number of cells of the inner nuclear and plexiform layers in the retinas of T1DM rats. Concomitantly, it reduced the retina levels of malondialdehyde (lipid peroxides), vascular endothelial growth factor, interleukin-6, tumor necrosis factor-α, Bax, and caspase-3. In the retinas of the control and diabetic rats, ESA boosted the levels of total glutathione, superoxide dismutase, heme-oxygenase-1, and Bcl2, reduced the mRNA levels of REDD1, and enhanced cytoplasmic and nuclear levels of Nrf2. However, ESA failed to alter the mRNA levels of Nrf2 and keap1, protein levels of keap1, plasma glucose, plasma insulin, serum triglycerides, cholesterol, and LDL-c in both the control and T1DM rats. In conclusion, ESA alleviates retinopathy in T1DM rats by suppressing REDD1-associated degradation and inhibiting the Nrf2/antioxidant axis.

Inverse relationship of serum IL-17 with type-II diabetes retinopathy.

BACKGROUND: Diabetes mellitus (DM) is a health concern because it leads to complications such as retinopathy. Pakistan has 6.9 million DM affected people that will double by 2025. A study was designed to determine the level of IL-17 in the serum of Pakistani type 2 diabetes mellitus (T2DM) patients. METHODS: It was a cross-sectional case-control study that included 212 subjects. Subjects without diabetes were labeled as Group-I (30 healthy volunteers), Group-II (30 T2DM without retinopathy), and Group-III (152 T2DM with retinopathy). The serum level of IL-17 was determined by ELISA technique. Data was analysed using SPSS 17.0 and one way ANOVA to observe group mean differences. RESULTS: More females were in Group-II (83%) and Group-III (66%) compared to Group-I (30%). The age of subjects was higher in Group-III (50 years) and Group-II (49 years) compared to Group-I (34 years). Group-III had longer mean duration of disease (10.51 years) than Group-II (7.76 years). Group-I had increased levels of IL-17 followed by Group-II and Group-III. On comparison, statistically significant differences were observed among the three groups, and between Group-I and Group-III, but there was no significant difference between Group-I and Group-II, nor between Group-II and Group-III. Further, on comparison of age, gender, and duration of disease there were significant differences while there was no significant difference between the percentages of HbA1c. CONCLUSIONS: Age, gender, and duration of diabetes may contribute in the development of T2DM retinopathy while serum level of IL-17 was inversely associated with T2DM and retinopathy.

Association between metabolically healthy obesity and metastasis in lung cancer patients - a systematic review and meta-analysis.

Background: Many clinical trials have looked at the relationship between obesity and lung cancer (LC), however, there is scarcity of literature specifically addressing the association between metabolically healthy obesity and metastasis in LC patients. To address this gap in the body of evidence, the study was conducted to observe the association between metabolically healthy obesity and metastasis in LC patients. Methods: We conducted a pre-registered systematic review by searching six major online databases to identify studies relevant related to our investigation, in adherence with the PRISMA guidelines. A proper data extraction protocol was further established to synthesize the findings from the selected papers through a meta-analysis. Results: Eleven (11) studies met the requisite selection criterion and were included in the study. A random-effect model was used. Obesity was found to have a significant impact on readmission in LC patients. The combined analysis showed a significant effect size of 0.08 (95% CI 0.07 to 0.08), indicating a noticeable impact of obesity. It was also assessed that obese individuals had a 34% reduced risk of LC compared to normal weight individuals. Obesity was associated with a lower risk of surgical complications with a pooled risk ratio of 0.13 (95% CI 0.12 to 0.14). A statistically significant decreased risk of LC (pooled RR = 0.72, 95% CI: 0.68 to 0.77) was also observed in the obese individuals. Conclusion: The analysis reveals that obesity is associated with a noticeable increase in readmissions, although the impact on LC risk itself is negligible. Moreover, obesity appears to have a beneficial effect by reducing the risk of surgical complications. These results highlight the complex relationship between the two aforementioned factors, emphasizing the importance of considering obesity as a significant factor in patient management and healthcare decision-making. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42023427612.

Enhancing Cardiovascular Health and Functional Recovery in Stroke Survivors: A Randomized Controlled Trial of Stroke-Specific and Cardiac Rehabilitation Protocols for Optimized Rehabilitation.

BACKGROUND: Stroke is a major contributor to disability and mortality globally. It leads to physical impairments, including weakness and cardiovascular deconditioning, posing significant challenges to stroke survivors' quality of life. Exercise-based cardiac rehabilitation has shown promise as a rehabilitation strategy. This study aims to assess and compare the impacts of stroke-specific rehabilitation and individualized cardiac rehabilitation exercises on various health parameters in stroke patients. METHODS: A randomized controlled trial was conducted, involving 38 stroke patients aged 40-75 years. Group A received stroke-specific rehabilitation, which consisted of a combination of range of motion exercises, strength training for the paralyzed side, balance and coordination training, gait training, functional mobility exercises, neuromuscular reeducation, and breathing exercises. This program was conducted five days per week for 12 weeks. Group B received individually designed cardiac rehabilitation exercises, in addition to stroke-specific rehabilitation. They engaged in this exercise for at least 30-45 min per day, four days per week, and incorporated two days of resistive training over a 12-week period. Baseline and post-intervention assessments included measures of cardiac autonomic function, balance (Berg Balance Scale), mobility (Timed Up and Go Test), cardiovascular fitness indicators, respiratory parameters, exercise efficiency, and perceived exertion. RESULTS: Group B receiving individualized cardio rehab showed significant improvements in balance and mobility compared to Group A receiving conventional stroke-specific rehab. Moreover, Group B exhibited enhanced cardiovascular fitness, respiratory performance, exercise efficiency, and autonomic function post-intervention. Notably, Group A displayed no significant improvements in these parameters. CONCLUSIONS: Individualized cardiac rehabilitation exercises demonstrated favorable outcomes in improving certain health parameters, highlighting the potential benefits of individualized rehabilitation strategies for stroke patients.

Comparing the Effectiveness of Role-Play Simulation versus Real Patient Transferal Skills Training in Occupational Therapy Students in Saudi-Arabia- A Quasi-Experimental Study.

Purpose: To compare the effectiveness of using role-play simulation as a possible alternative to real-patient training to teach transferal skills to occupational therapy students. Patients and Methods: Seventy-one occupational therapy students (including those in their second, third and fourth years) participated in a quasi-experimental study. The students were randomly divided into two groups. One group received role-play simulation at the university. The other received training on real patients with mild to moderate stroke and spinal cord injury (one session/week for six weeks) in clinical (inpatient) settings in Jeddah to learn patient transferring skills. Student performance was taken as a measure of teaching method effectiveness, and was evaluated by using a validated OSCE-type assessment tool developed at the end of training. The tool showed good reliability (Cronbach's α was > 0.7) and inter-reliability (Kappa < 0.001). Results: A total number of 71 students participated in the study. The majority of the students were female (66.2%, N=47) and 33.8% (N=24) were male. About 33.8% (N=24) of students were in the second year, 29.6% (N=21) were in the third year and 36.6% (N=26) were in the fourth year. There were 36 (49.3%) students in the simulation group The mean age of the students was 20.70 (SD=1.2). There was no significant difference in the students' performance in both groups with a P-value of 0.139. Conclusion: Role-play simulation can effectively be used for students' training as there was no difference in the outcome of the students' performance in patient transferring skills in both groups. This finding can help in designing and implementing training through simulation, especially in situations where training on severely ill patients may be a safety risk.

A Single Centre, Randomized Control Trial Of Donor Site Wound Dressings After Split-Thickness Skin Grafting.

BACKGROUND: Split-thickness skin grafting (STSG) is a widely employed technique for repairing wounds, such as ulcers, trauma, or in reconstructive surgeries. The objective was to compare the efficacy of different dressing materials for healing donor-site wounds after split-thickness skin grafting. METHODS: A single center, randomized controlled trial was conducted at the Department of Plastic Surgery, Civil Hospital Karachi, Pakistan, over a period of six months. The study included patients aged 18 years and above, of both genders, who underwent single donor-site wounds after split-skin grafting with a surface area larger than 10 cm². The eligible patients were randomly divided into six groups: Film, Alginate, Gauze, Hydrofiber, Hydrocolloid, and Silicone. Pain, itching, scarring, complications, and patient satisfaction were evaluated after 12 weeks using standardized assessment scales. RESULTS: The median time to complete wound healing and re-epithelialization varied among the different dressing groups, with hydrofiber and silicone dressings demonstrating the shortest healing time. Statistical analysis revealed a significant difference in the median time to complete wound healing among the dressing groups (p-value=0.019). However, no significant differences were observed in pain, itching, scarring (POSAS observer and patient), or patient satisfaction among the different dressings (p-value>0.05). CONCLUSIONS: Although the dressing type did not significantly affect pain, itching, scarring, or patient satisfaction, variations were observed in the time to complete wound healing. These findings contribute to the selection of appropriate donor site dressings for optimizing outcomes in split-skin grafting procedures.

Oral Health Statuses of Children and Young Adults with Autism Spectrum Disorder: An Umbrella Review.

This study aimed to comprehensively evaluate the oral health statuses of children and adults within the autism spectrum disorder (ASD) population through an umbrella review approach. The prevalence of dental caries, periodontal disease, and associated variables were investigated across selected studies. A systematic search was conducted across databases including PubMed, Scopus, EMBASE, Science Citation Index, Science Direct, Web of Science, MEDLINE, and Wiley Online Library to identify relevant studies. The assessed variables included dental caries prevalence, periodontal disease prevalence, oral hygiene indicators, and the necessity of dental treatment. The pooled prevalence rates, odds ratios, and standardized mean differences were calculated where applicable. The pooled prevalence of dental caries among ASD individuals ranged from 60.6% to 67.3%, while the periodontal disease prevalence ranged from 59.8% to 69.4%. High rates of dental treatment under general anesthesia were reported. Heterogeneous dental caries and periodontal disease prevalence rates were identified, highlighting the need for collaboration and preventive care. Several studies also reported higher prevalence rates of dental trauma and self-inflicted oral injuries among individuals with ASD. However, the review also identified significant methodological limitations in the included studies, including inconsistency in oral health assessment methods and potential bias. The necessity for targeted policies due to high prevalence rates and the requirement for integrated care systems in high DMFT regions were also observed. The umbrella review synthesized diverse findings, revealing variations in dental caries and periodontal disease prevalence among ASD individuals. This review underscores the need for tailored interventions and policies to address oral health disparities. It highlights the necessity of integrated care systems, methodological improvements, and longitudinal studies to comprehensively address the multifaceted oral health challenges within the ASD population.