A comparison of the assessments used in campus-based years at the College of Medicine, Imam Abdulrahman Bin Faisal University, Saudi Arabia.

STUDY PURPOSE: Multiple assessment tools are used to assess future doctors' knowledge, clinical skills, and professional attitudes. In the present research, the difficulty level and discriminating ability of different types of written and performance-based assessments designed to measure the knowledge and competency of medical students were compared. METHODS: The assessment data of 2nd & 3rd-year medical students (the academic year 2020-2021) in the College of Medicine at Imam Abdulrahman Bin Faisal University (IAU) were retrospectively reviewed. Based on end-of-the-year overall grades, students were divided into high and low scorers. Both groups were compared by independent sample t-test for their mean scores achieved in each type of assessment. Difficulty level and discriminating ability of the assessments were also explored. MS Excel and Statistical Package for Social Sciences (SPSS version 27) were used for analysis. Area under the curve was calculated through ROC analysis. A p-value <0.05 was believed significant. RESULTS: In each type of written assessment, the high scorer group achieved significantly higher scores compared to the low scorers. Among performance-based assignments (except the PBLs), scores did not differ significantly between high and low scorers. The difficulty level of performance-based assessments was "easy" whereas it was "moderate" for written assessments (except the OSCE). The discriminating ability of performance-based assessments was "poor" whereas it was "moderate/excellent" for written assessments (except the OSCE). CONCLUSION: Our study results indicate that written assessments have excellent discriminatory ability. However, performance-based assessments are not as difficult and discriminatory as written assessments. The PBLs are relatively discriminatory among all performance-based assessments. Key messages What is already known on this topic At Imam Abdulrahman Bin Faisal University, written and performance-based assessments both are graded on criterion-referenced scales. The student's grades at the end of the year are an aggregate of his/her scores in written and performance-based assessments. What this study adds Our study results show that performance-based assessments are not as difficult and discriminatory in differentiating between high and low scorers as written assessments. How this study might affect research, practice or policy Performance-based assessments should be made a hurdle exam (pass or fail) for the students to move to the next level, or students must pass each assessment component (written and performance-based) separately.

Hospital Work Conditions and the Mediation Role of Burnout: Residents and Practicing Physicians Reporting Adverse Events.

Background: "Patient Safety" in everyday practices is a target of healthcare leaders, and adverse events reported by healthcare providers directly reflect patient safety in the health system. Recognising how residents and practising physicians rate adverse events concerning their work conditions and burnout must be explored. Objective: This study aims to explore the mediation effect of burnout dimensions (emotional exhaustion and burnout-interpersonal disengagement) between the effects of work conditions on perceived patient safety by exploring the adverse events that residents and practising physicians reported. Methods: A quantitative and cross-sectional study collected data from 249 residents and practising physicians in a huge teaching hospital and primary health care centre (PHC) in the Eastern Province of Saudi Arabia. Hayes Macro regression analysis was employed to evaluate the multiple mediation effect of burnout dimensions, with 5000 bootstrapping and a confidence interval (CI) of 95% for statistical inference and p≤0.05 for the significance level. Results: Leadership support (B= 0.39, t= 6.24, p<0.001) and physician engagement (B=0.43, t=6.50, p<0.001) were associated with a decreased rate of adverse events to patient safety, whereas workload (B=-0.23, t=-3.73, p<0.001) was negatively associated with an increased rate of adverse events. Burnout was shown to mediate the relationship between the effects of physician's leadership support (R2=0.26, F=27.50, p<0.001), work engagement (R2=0.25, F=27.07, p<0.001) and workload (R2=0.23, F=24.23, p<0.001) on the rate of adverse events. Conclusion: This study provides insights into burnout dimensions and their consequences on patient safety indicators (ie, adverse events). Work conditions (ie, leadership support, physician engagement, and workload) directly affect the rate of adverse events and indirectly through mediators like burnout-emotional exhaustion and burnout-interpersonal disengagement.

Internet gaming disorder and its correlates among university students, Saudi Arabia.

BACKGROUND: Over-indulgence in online/offline video games could result in the development of internet gaming disorder (IGD). Knowledge of the prevalence and correlates of IGD may help to understand its etiology. The aim of the present study was to estimate IGD and its psychological/game-related correlates in Saudi university students. MATERIALS AND METHODS: For this cross-sectional study, 843 students registered in a university in Saudi Arabia filled an online survey comprising diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), hospital anxiety and depression scale, Rosenberg self-esteem scale, social phobia inventory scale, satisfaction with life scale, and subjective happiness (SH) scale. For data analysis, an independent sample t-test, Pearson correlation coefficient/Chi-square test, and multiple linear regression followed by hierarchical regressions were used. RESULTS: The frequency of IGD was 21.5%. Total game time/day, years of playing games, and social phobia were significantly higher in subjects with IGD (P = 0.001, <0.001, and <0.001, respectively), whereas SH was significantly lower (P < 0.001). Tendency to IGD had a significant positive correlation with social phobia, total game time/day, and years of playing games and a negative correlation with SH. Total game time/day, years of playing games, and social phobia were significant positive predictors of tendency to IGD, whereas SH was a negative predictor. The rest of all variables were insignificant predictors. CONCLUSION: The frequency of IGD in Saudi university students identified by DSM-5 criteria was relatively high (21.5%). The prediction of the severity of IGD could be based on social phobia, total game time/day, number of years of playing games, and SH.

Association Between Time Spent on Electronic Devices and Body Mass Index in Young Adults.

Objective: To evaluate the association between time spent on electronic devices (TSED) and body mass index in young adults. Methods: This cross-sectional study was conducted from June to December 2021 on 1877 students (aged 18-22 yrs) from multiple health Colleges of Imam Abdulrahman Bin Faisal University. The main tools of the study were 1) Body mass index (BMI) and an online questionnaire. The subjects were categorized into 3 main groups based on their TSED: 1) Low TSED < 2 hours/day, 2) Medium TSED= 3 to 5 hours/day, 3) Excessive TSED ≥ 6 hours /day. Based on BMI, subjects were categorized into three main groups: Normal and underweight (BMI ≤ 24.9), overweight (BMI > 25-29.9), and obese (BMI > 30). Results: Participants' average age was 20 ± 2 years. The average BMI was 23.5 k/m2. The % of students falling into the categories of normal weight, overweight, and obesity was 69.2%, 19.05%, and 11.7% respectively. The average TSED of study participants was 8.2 ± 3.45 hrs /24 hours. 71.15% of participants indicated a TSED of ≥6 hrs/24 hours and 23.71% reported a TSED of 3-5 hrs/24 hours. Only 3.15% of participants reported TSED of ≤2 hrs/24 hours. Although a rise in the mean BMI was observed with an increase in the TSED, but this difference was not statistically significant. The pairwise wise comparison also failed to demonstrate any difference in BMI between different categories of TSED. Furthermore, no significant positive correlation was found between increased BMI and excessive TSED (P = 0.37). Conclusion: A high percentage of young adults (31.2%) were overweight or obese, but excessive TSED was not significantly associated with increased BMI in this study population. Further studies are recommended to identify the effects of other factors in causing increased BMI in young adults.

Factors Affecting Health Care Professionals' Adherence to COVID-19 Precautionary Measures.

Objective: COVID-19 is a public health emergency of international concern. There is still no definitive cure for this highly transmittable illness. Immunization and breaking the chain of infection is the only successful approach to mitigate its spread. Our study explored the adherence to COVID-19 preventive measures and its associating factors among Health Care Professionals (HCPs) working in Saudi Arabia. Methods: For this cross-sectional study, an online survey was conducted from December 01, 2020, to March 31, 2021, among 978 HCPs in Saudi Arabia. The self-administered questionnaire consisted of demographic information, COVID-19 preventive behaviors, knowledge, attitude, fear, and risk. Mann-Whitney U-test, Kruskal-Wallis one-way analysis, Spearman correlation, and binary logistic regression tests were used in data analysis. Results: Most of the HCPs were Saudi nationals (86.9%), females (63.1%), age group 20-29 years (42.3%), Middle Eastern ethnicity (82.5%), and working in the government sector (80.8%). A 52.2% of the participants were compliant with COVID-19 preventive behavior. The most and the least compliant preventive behaviors were "wearing masks" (88.8% compliance) and "keeping social distancing" (60.7% compliance). Preventive behavior was significantly higher in HCPs having a) more knowledge of COVID-19 (U=104849; p 0.001); b) positive attitude (U=84402; p 0.001); c) higher fear (U=103138; p less than 0.001) and d) nursing profession (p 0.01). COVID-19 knowledge (p<0.001), attitude (p<0.001), and fear (p<0.001) contributed significantly to the prediction of preventive behavior compliance. A unit increase in COVID-19 knowledge, attitude, and fear scores raised the odds of being compliant with preventive behavior by factors of 2.34, 1.87, and 1.53 respectively. Conclusion: About half of the study participants were compliant with COVID-19 preventive behavior. Preventive behavior is significantly higher among HCPs having more knowledge of COVID-19, more fear, a positive attitude, and the "nursing" profession. Having more knowledge, a positive attitude, and more fear of COVID-19 may increase the likelihood of being compliant with preventive behavior.

The Psychological Impact of COVID-19 on Residents of Saudi Arabia.

Purpose: This study aimed to determine the stress levels and identify various factors responsible for causing high-stress scores during the COVID-19 pandemic in the Saudi population. Patients and Methods: This cross-sectional study was conducted at Imam Abdulrahman Bin Faisal University, Dammam, from June 2020 until December 2020 on 4052 respondents from the Eastern province of Saudi Arabia. An online survey was used to collect information about various stress factors. The psychological impact of COVID-19 was measured by using the COVID-19 impact event scale (COVID-19 IES), whereas general stress levels were assessed by K10 Kessler Psychological Distress Scale (K10). Results: The psychological impact of the COVID-19 outbreak revealed that 35.4% of participants suffered from moderate or severe psychological impact (score>33); 19.7% had a mild psychological impact (scores24-32), whereas 44.9% reported minimal psychological impact (score <23). The factors significantly associated with higher stress scores and COVID-19 IES included male gender, low monthly income, having a private business, living in apartments/residential complexes, poor general health status, visit hospital/doctor in the past three months, presence of chronic disease, direct/indirect contact with someone diagnosed with/suspected to have COVID-19, contact with surfaces/tools infected with COVID-19, getting screened or quarantined for COVID-19, follow-up of the latest news about COVID-19 and knowledge of a greater number of people infected and died with COVID-19 (p < 0.05). In contrast, being an elementary school student, having 4-10 children, observing various protective measures, and staying home for 4-12 hours were associated with lower COVID-19 IES (p < 0.05). Conclusion: During the initial six months of the COVID-19 outbreak in Saudi Arabia, 35.4% participants suffered from moderate to the severe psychological impact. This study identified various factors responsible for high COVID-19 IES and K10 stress scores. These findings can help formulate psychological interventions for improving the stress scales in vulnerable groups during the COVID-19 pandemic.

Association between sex hormones and migraine in young Saudi females.

OBJECTIVES: To assess the sex hormone levels in young Saudi female migraineurs during a migraine attack and during pain-free periods and compare them with control subjects. METHODS: A case-control study involving 14 Saudi female migraineurs and 21 control subjects was conducted between December 2019 and March 2020. Demographic and disease history data were collected through participant interviews. Blood samples were drawn during the migraine attack and pain-free periods. RESULTS: Follicular (30.00±19.60; p<0.001) and luteal (39.79±11.45; p=0.037) estrogen levels were significantly higher in patients with non-menstrual related migraine (NMM), while luteal testosterone levels (1.10±0.31; p=0.023) were significantly higher in patients with menstrually related migraine (MM). Body mass index (BMI) was higher in patients with NMM (25.77±6.53; p=0.013), and it was found to be associated with follicular estrogen (p=0.016), progesterone (p=0.018), and pain intensity (p=0.042). Luteal estrogen level was significantly lower (13.96±7.88; p=0.036) in patients with luteal onset of attack. CONCLUSION: High estrogen levels were found to mediate NMM, their effect being more pronounced with increase in BMI; whereas low luteal estrogen levels mediated MM. Young females with MM might have high luteal testosterone levels, and a compensatory protective role could be surmised accordingly.

Higher emotional investment in social media is related to anxiety and depression in university students.

OBJECTIVES: Most studies that have reported the adverse effects of social media (SM) usage on mental health have been conducted on adolescents. Additionally, such studies have used frequency or duration as the only indicator of SM usage. The present study aims to relate SM usage (frequency, duration, and emotional investment) with anxiety, depression, and self-esteem in university students. METHODS: In this cross-sectional study, we adapted a non-probability convenience sampling technique. The data from 893 university students was collected through questionnaires, which were developed in Google forms and their links were shared in social media groups. The study tools used were Hospital Anxiety and Depression Scale, Rosenberg self-esteem scale, Social Integration and Emotional Connection subscale of the Social Media Use Integration Scale. We recorded variables for overall SM use (volume and frequency), night-time specific SM usage, emotional investment in SM, anxiety, depression, and self-esteem levels. Based on the scores achieved in SM variables, participants' data were classified into different quartiles. RESULTS: We found a significant positive correlation of emotional investment in SM with anxiety (r = 0.71; p-value < 0.001) and depression (r = 0.72; p-value 0.003). The results of the one-way ANOVA revealed significantly increased anxiety and depression scores (p-value 0.03 and 0.02, respectively) in quartile four versus quartile one. The probability or likelihood of being anxious and depressed significantly increased by factors of 1.76 and 1.48, respectively with per unit increase in emotional investment in SM. CONCLUSION: Higher Emotional Investment in Social Media is related to Anxiety and Depression in University Students. The probability of being anxious and depressed significantly increases with per unit increase in emotional investment in SM.

Diagnostic Accuracy of Serum Calcitonin Gene-Related Peptide and Apolipoprotein E in Migraine: A Preliminary Study.

BACKGROUND: A reliable, migraine-specific biomarker has not been identified so far. Calcitonin Gene-Related Peptide (CGRP) and Apolipoprotein E (ApoE) might serve as migraine biomarkers due to their roles in migraine pathophysiology. However, their diagnostic usefulness has not been explored yet. Present study explored the diagnostic accuracy of CGRP and ApoE in migraine. METHODS: A cross-sectional, case-control study was conducted from November 2019 to April 2020 at Physiology department of our university. Fourteen female migraine patients, 18-25 years old, with confirmed "Migraine" diagnosis by a neurologist, were recruited. Control group consisted of 14 age-matched healthy females with no personal/family history of migraine. Blood was drawn once from control subjects and twice from migraine patients (ictal and interictal phase). Serum CGRP and ApoE levels were assessed by ELISA. Statistical analysis involved paired t-test, one-way ANOVA, Receiver operating characteristic (ROC) curves and cross-tabs. RESULTS: ApoE (mg/dl) was higher significantly in interictal (1.90±0.50) and ictal (1.97±0.65) phases of migraine compared to control (1.07±0.26) (p ≤ 0.001). ROC curves for ApoE were significant in migraine ictal vs control (AUC= 0.91, AUC 95% CI: 0.78-1.0) and migraine interictal vs control (AUC=0.92, AUC 95% CI: 0.8-1.0) subjects. ROC curve for CGRP (pg/mL) was significant in migraine ictal vs control subjects only (AUC=0.79, AUC 95% CI: 0.6-0.97). CONCLUSION: Serum ApoE has "excellent" accuracy to diagnose migraine patients whether in ictal or interictal phase, from healthy subjects. ApoE levels of patients in these two phases of migraine are raised significantly than healthy subjects. CGRP has "fair" diagnostic accuracy to discriminate between migraine ictal phase and healthy subjects. Its levels do not differ significantly among migraine ictal, interictal phase and healthy controls.

Effectiveness of case-based teaching of cardiovascular physiology in clinical pharmacy students.

OBJECTIVE: This study aimed to formulate and implement a case-based cardiovascular physiology module for second year clinical pharmacy (CP) students. We also evaluated the students' feedback and compared the academic performance between a case-based teaching (CBT) group and a traditional didactic lectures (TDL) group. METHODS: This descriptive quantitative study was conducted on 181 students who were divided into two groups. Group 1 (77 students) underwent TDL and the same topics were delivered to Group 2 (94 students) through CBT. A written examination was conducted at the end of both modules. A validated questionnaire was used to obtain feedback from the CBT group regarding CBT and their assessment grades (response rate - 93.6%). RESULTS: Students' feedback about CBT was positive. The majority of students, 63 (72%), preferred learning and understanding through CBT, finding it an enjoyable experience. Participants stated that CBT stimulated critical thinking (67; 76%) and linked theory to practice (69, 78%). Furthermore, 70 (80%) preferred this type of teaching and assessment in the future and 70 (80%) agreed to include CBT in all preclinical subjects. Students feedback was supported by exam results: the mean percentage of exam scores in the CBT group was significantly higher in comparison to the TDL group (81.2% vs. 79%, p value <0.05). Further comparison within the CBT group revealed improved student performance in "case-based" as compared to "conventional" questions (82.75% vs. 80%, p value <0.05). CONCLUSION: Students greatly appreciated CBT, as it stimulated logical thinking and active participation in the class, resulting in improved performance in exams.

Effect of energy drink consumption on baroreceptor sensitivity in young normal weight and overweight/obese males.

OBJECTIVES: There is lack of evidence exploring sympathetic effect by baroreceptor sensitivity in obese consuming energy drink. The purpose of this study was to investigate the acute effect of energy drink on individuals baroreceptor sensitivity in young healthy normal weight and overweight/obese males. METHODS: This cross-sectional study was performed in the Department of Physiology, Imam Abdulrahman Bin Faisal University, Kingdom of Saudi Arabia. After getting ethical approval, 25 male participants were recruited by convenient sampling and informed consent was obtained. Participants were grouped into normal weight and overweight/obese on basis of body mass index. Finger arterial blood pressure was recorded with Finometer® at baseline, 30min and 60 minutes in the post-energy drink period and baroreceptor sensitivity was calculated. As data was not normally distributed it was log transformed. RESULTS: The baseline baroreceptor sensitivity was lower (P<0.05) in overweight/obese compared to normal weight participants. Baroreceptor sensitivity reduced significantly (P<0.05) at 60 minutes after energy drink consumption in the whole cohort of both normal weight and overweight/obese. Baroreceptor sensitivity remained lower in overweight/obese compared to normal weight at 60min but the difference was not significant. CONCLUSION: Consumption of energy drink acutely reduced baroreceptor sensitivity in both normal weight and obese young healthy males with an earlier onset of effect in overweight/obese indicating enhanced sympathetic activity. Energy drinks consumption could place the obese in a more vulnerable state to hypertension and arrhythmia.

Assessment of baroreceptor reflex sensitivity in young obese Saudi males at rest and in response to physiological challenges.

Autonomic imbalance in overweight/obese persons could lead to an increased risk of cardiovascular complications including hypertension and arrhythmias. Baroreceptor reflex sensitivity is a sensitive indicator to detect an altered sympathovagal balance in overweight/obese individuals. This study investigated the effects of overweight/obesity on baroreceptor sensitivity in young Saudi males at rest and in response to physiological challenges. SUBJECTS AND METHODS: In this cross-sectional study, spontaneous baroreceptor sensitivity at rest and in response to deep breathing, isometric hand grip exercise and moderate intensity isotonic exercise were recorded in 20 normal weight and 20 overweight/obese subjects. Finger arterial blood pressure signal, recorded through Finometer, was used to calculate baroreceptor sensitivity through cross-correlation method. The baroreceptor sensitivity data were log transformed before application of parametric tests. RESULTS: The spontaneous baroreceptor sensitivity was similar in both groups at baseline, but exhibited a significant increase during deep breathing only in normal weight (p < .001). Immediately after the isotonic exercise the baroreceptor sensitivity was significantly lower than baseline in both normal weight and overweight/obese and remained significantly lower in overweight/obese individuals compared to normal weight (p < .05) throughout the recovery period. There was a significant rise in baroreceptor sensitivity after isometric exercise in overweight/obese group only (p = .001). Pearson's correlation showed a significant negative correlation of baroreceptor sensitivity with body mass index during deep breathing (r = -.472, p = .004) and in post-isotonic exercise recovery period (r = -.414, p = .013). CONCLUSION: A significantly reduced baroreceptor sensitivity response to deep breathing, reduced baroreceptor sensitivity recovery after isotonic exercise, and an exaggerated shoot up after isometric exercise in overweight/obese suggests an altered sympathovagal balance. Baroreceptor sensitivity measurements in response to physiological challenges, deep breathing, and isotonic exercise, may be more sensitive investigations for detection of early attenuation of cardiac autonomic function. This would enable timely intervention thereby delaying complications and improving the quality of life.

Prevalence of Migraine and its Relationship with Psychological Stress and Sleep Quality in Female University Students in Saudi Arabia.

PURPOSE: This study aimed to determine the prevalence of migraine in young female adults and to identify if a relationship exists between psychological stress or poor sleep quality and migraine. MATERIALS AND METHODS: This case control study was carried out at Imam Abdulrahman Bin Faisal University (IAU), Dammam, KSA from March 2019 to March 2020 on 1,990 female students (17- to 26-years-old). The study tools were Migraine Screening Questionnaire (MS-Q), International Headache Society (IHS) Criteria for Migraine, K10 Psychological Distress Instrument (K10) and Pittsburgh Sleep Quality Index (PSQI). RESULTS: A total of 103 out of 1,990 (5.17%) participants were identified to have migraine. Migraineurs compared to controls had significantly higher average stress scores; felt more tired, nervous, restless, could not sit still, felt that everything was an effort, and nothing cheered them up (p values; 0.008, 0.001, 0.02, 0.01, 0.004, 0.009, 0.02 respectively). Moreover, presence of migraine was significantly correlated with various stress parameters including "High K10 scores," "being tired," "being nervous," "restlessness," "inability to sit still," and "feeling that everything is an effort" (p values: 0.01, 0.002, 0.018, 0.01,0.005, 0.01,0.02). Regarding sleep quality and sleep parameters, no statistically significant difference was found between migraineurs and controls. No correlation was found between presence of migraine and poor sleep quality. CONCLUSIONS: The results of this study indicate that 5.17% of young females (17- to 26-years-old) suffer from migraine. It also concludes that poor sleep quality is not correlated with migraine, whereas high stress scores are significantly correlated with migraine in young female adults.

Changes in Heart Rate Variability and Baroreflex Sensitivity During Daytime Naps.

BACKGROUND AND OBJECTIVES: Changes in autonomic cardiac activity during night sleep are well documented. However, there is limited information regarding changes in the autonomic cardiac profile during daytime naps. Heart rate variability (HRV) and baroreflex sensitivity (BRS) are reliable measures of autonomic cardiac activity. The purpose of this study was to determine the changes in HRV and BRS during daytime naps in healthy men. METHODS: This was a cross-sectional study of 25 healthy men. Polysomnographic recording with electrocardiogram monitoring was conducted for all volunteers during a 50-80 min nap between 3.30 pm and 5.30 pm. Five-minute segments during pre-nap wakefulness, non-rapid eye movement (NREM) sleep stages (N1, N2, and N3), rapid eye movement (REM) sleep stage, and post-nap wakefulness were used to measure changes in the variation in HRV parameters, including inter-beat interval (RR-interval), total spectral power (TP), high-frequency power (HF), low-frequency power (LF), and low frequency/high-frequency ratio (LF/HF). BRS was also measured for 10 min during pre- and post-nap wakefulness using finger arterial pressure measurement (Finometer Pro ®). RESULTS: HRV increased significantly during NREM sleep compared with that during pre-nap wakefulness (p < 0.05), as reflected by RR-interval prolongation, higher HF, and increased HFnu (normalized units). Furthermore, there was a parallel reduction in TP, LF, and LF/HF ratio during NREM sleep, indicating parasympathetic predominance over cardiac autonomic activity. HF and HFnu were significantly reduced during REM sleep compared with that during NREM sleep (p < 0.05). BRS did not show significant differences between pre- and post-nap wakefulness. CONCLUSION: We observed a progressive increase in parasympathetic activity during daytime sleep as NREM sleep deepened compared with that during wakefulness and REM sleep. Daytime nap may have a favorable cardiovascular impact.

Effect of modified physiology laboratory sessions on the awareness and knowledge of obesity of health-related university students.

BACKGROUND: Obesity is a global health problem of immense magnitude. Increased awareness and knowledge about obesity in health-care providers are essential to addressing this global issue. The aim of the present study was to assess the baseline knowledge on obesity of university students in health-related programs and evaluate the effectiveness of modified physiology laboratory (MPL) sessions in enhancing the awareness of obesity of these students by repeated exposure to physiological differences between normal weight (NW) and overweight or obese (OW/OB) individuals. MATERIALS AND METHODS: It was a quasi-experimental study in which three regular physiology laboratory exercises were modified (MPL) to address different aspects of obesity. A total of 319 students (181 male and 138 female) from health-related colleges taking the physiology course during academic session 2011-2012 were included in the study. A questionnaire on obesity served as a measure of prior knowledge and improvement of evolution of student knowledge. The questionnaire was administered thrice: Beginning of the first MPL session (pretest), at the end of the second session of the first MPL (posttest-1), and the end of second session of the final MPL (posttest-2). Correct knowledge (CK), perceived knowledge (PK), and accuracy of knowledge (KA) were evaluated. Students gathered and analyzed physiological data in these sessions to explore the differences between NW and OW/OB subjects. RESULTS: The students' level of PK on obesity was high, but KA was low in pretest. The three knowledge indices improved significantly (P <0.001) from pretest (PK = 77.2%; KA = 52.8%; CK = 40.5%) to posttest 1 (PK = 93.5%; KA = 70.1%; CK = 65.9%). However, from posttest 1 to posttest 2, only small but significant increments were observed in CK (10.5%) and KA (8.7%). CONCLUSION: The awareness and knowledge on obesity of health-related undergraduate university students at baseline were low, but significantly improved after MPLs. The students' knowledge did not only increase but also improved in accuracy. This increase in awareness and knowledge of obesity is expected to directly impact on the students' lifestyles and boost their confidence to counsel others on obesity.

Effects of Chocolate Intake on Oxidative Stress/Oxidant-antioxidant Balance in Medical Students: A Controlled Clinical Trial.

BACKGROUND AND AIM: Cocoa polyphenols have been shown to exhibit antioxidant properties in vivo and in vitro. This study aimed to determine whether commercially available chocolate could improve oxidant/antioxidant balance in medical students. MATERIALS AND METHODS: Sixty students (30 males and 30 females) were given three different types of chocolate. Subjects were divided equally into three groups of 20 students (10 males and 10 females) as follows: (i) Dark chocolate group (DC), (ii) milk chocolate group (MC), and (iii) placebo group (PC). The placebo group was given white chocolate. Blood was drawn at baseline and after consumption of chocolate (40 g/day) for 2 weeks. Serum was analyzed for DNA/RNA oxidative damage, thiobarbituric acid reactive substances (TBARS), superoxide dismutase (SOD), and glutathione peroxidase (GPX) enzymes. Descriptive analyses were conducted to determine the frequency distributions of the study variables. Means were compared across the study groups by one-way Analysis of Variance and within the same group by paired t-test. RESULTS: Mean serum DNA/RNA damage, TBARS, SOD, and GPX enzymes compared between the groups revealed insignificant differences after 2 weeks of chocolate consumption (P = 0.46, 0.19, 0.11, and 0.06). Comparison within the same group also exhibited statistically insignificant differences in DNA/RNA damage in DC and MC groups (0.29 and 0.46, respectively); TBARS in DC and MC groups (0.11 and 0.19, respectively); SOD in DC and MC groups (0.06 and 0.11, respectively); and GPX in DC and MC groups (0.68 and 0.78, respectively). CONCLUSION: Consumption of 40 g of DC or MC daily for a period of 2 weeks appears to be an ineffective way of improving oxidant/antioxidant balance in medical students.

Effect of energy drink intake before exercise on indices of physical performance in untrained females.

OBJECTIVES: To determine the effect of energy drink consumption before exercise on indices of physical performance in untrained females. METHODS: This single blind placebo controlled experimental study was carried out at the Physiology Department, University of Dammam, Dammam, Kingdom of Saudi Arabia from September 2011 to May 2012, on 32 healthy female students, in a crossover design. They were given either a standardized energy drink or the placebo 45 minutes before the exercise. Time to exhaustion and the stages of Bruce protocol achieved were noted. Heart rate, blood pressure, peripheral capillary oxygen saturation, and blood lactate were recorded before and after the exercise. Maximum oxygen consumption (VO2max) was calculated by formula. Paired sample t-test was used for statistics. RESULTS: The mean age was 19.93±0.8 years, mean height 156.40±3.83 cm, and the mean weight 51.73±3.65 kg. Time to exhaustion in the placebo group was 11.67±1.51 minutes and 11.41±1.56 in the energy drink group (p less than 0.157). The VO2max in the placebo group was 34.06±6.62, while it was 32.89±6.83 in the energy drink group (p less than 0.154). There were no significant differences between the placebo and the energy drinks groups in regards to heart rate, blood pressure, and blood lactate levels, before or after the exercise. However, there were significant differences before, immediately, and 30 minutes post exercise for all parameters between each group. CONCLUSION: The effects of energy drinks intake on physical performance during the exercise in our small sample does not significantly differ from placebo.

Determinants of misconceptions about diabetes among Saudi diabetic patients attending diabetes clinic at a tertiary care hospital in Eastern Saudi Arabia.

OBJECTIVE: To identify the determinants of misconceptions about diabetes in patients registered with a diabetes clinic at a tertiary care hospital in Eastern Saudi Arabia. MATERIALS AND METHODS: This cross-sectional survey was carried out at a diabetes clinic of a tertiary care hospital in Eastern Saudi Arabia, from January to December 2012. A total of 200 diabetic patients were interviewed using a questionnaire comprising 36 popular misconceptions. The total misconception score was calculated and categorized into low (0-12), moderate (13-24) and high (25-36) scores. The association of misconception score with various potential determinants was calculated using Chi-square test. Step-wise logistic regression was applied to the variables showing significant association with the misconception score in order to identify the determinants of misconceptions. RESULTS: The mean age was 39.62 ± 16.7 and 112 (56%) subjects were females. Type 1 diabetics were 78 (39%), while 122 (61%) had Type 2 diabetes. Insulin was being used by 105 (52.5%), 124 (62%) were self-monitoring blood glucose and 112 (56%) were using diet control. Formal education on diabetes awareness had been received by 167 (83.5%) before the interview. The mean misconception score was 10.29 ± 4.92 with 115 (57.5%) subjects had low misconception scores (<12/36). On the Chi-square test, female gender, rural area of residence, little or no education, <5 or >15 years since diagnosis, no self-monitoring, no dietary control and no diabetes education were all significantly (P < 0.05) associated with higher misconception scores. Step-wise logistic regression suggested that diabetes education, gender, education and time since diagnosis were significant (P < 0.05) predictors of misconception scores. CONCLUSIONS: The strongest determinants of misconceptions about diabetes in our study population were female gender, rural area of residence, illiteracy or little education, <5 or >15 years since diagnosis, no self-monitoring, no diet control and no education about diabetes.

Energy drinks consumption pattern, perceived benefits and associated adverse effects amongst students of University of Dammam, Saudi Arabia.

BACKGROUND: There are safety concerns about energy drinks alongside marketing claims of physiological and behavioural benefits. There is no scientific data about usage of energy drinks in Saudi Arabia. This study determined consumption patterns of energy drinks as well as perceived benefits and side effects amongst students at a Saudi university. METHODS: This study was carried out in students of University of Dammam from October to December 2010. A questionnaire about energy drink use, reasons for use, benefits and side effects experienced was distributed amongst the university students. Frequencies of responses and differences between male and female students were analysed. RESULTS: A total of 412 students (282 males and 130 females) responded, out of whom 54.60% males and 26.15% female students were energy drink users. Mean age at first use was significantly (p<0.05) less in female students. Inspirations for first time use were friends (both genders) and curiosity (males mainly). Most students did not have a fixed frequency of use. The commonest reasons for use were company of friends, to keep awake, for more energy and for better performance in driving, sports or exams. Amongst many the commonest (p<0.05) benefit reported was ability to stay awake longer. The students reported a number of adverse effects. Increased urination and insomnia were the commonest in males and females respectively. Only 36.70% males and 14.28% females never experienced an adverse effect. CONCLUSION: A significant proportion of students at university of Dammam use energy drinks, they have reported a number of effects (perceived as benefits) along with a variety of adverse effects.