Outpatient pediatric cardiology consultations in a tertiary academic hospital.

Objectives: Cardiac diseases in the pediatric population can be congenital or acquired. If the diagnosis and treatment are early, the chance for survival increases. Thus, this study aimed to determine the indications for pediatric cardiology consultations in a single tertiary hospital in Jeddah, Saudi Arabia. Materials and Methods: This study was conducted in 2020-2021 at a tertiary center in Jeddah, Saudi Arabia. Patients younger than 14 years of age who were referred by outpatient clinics or those who presented to the emergency department and needed outpatient cardiac evaluation were included in this study. Inpatient referrals were excluded. The Statistical Package for the Social Sciences version 21 was used for statistical analyses. Results: A total of 416 referred patients were included in this study. New patients accounted for 74% of the referrals, while known patients accounted for 26%. The median age was 2.728 years, with 56.3% being male participants. The three most common reasons for referral were: evaluation of cardiac function (21.6%), follow-up evaluation of fetal/neonatal diagnosis (19.5%), and heart murmurs (16.8%). Conclusion: Most of the referrals were new patients. Of those who underwent echocardiography, 48.2% had abnormal results. We recommend further studies to help guide the direction of the residents' education and to provide better patient healthcare services.

Effect of Obesity on Clinical Outcomes in COVID-19 Patients.

Background Obesity is a well-known risk factor for developing severe coronavirus disease 2019 (COVID-19). In this study, we sought to determine the relationship between obesity and poor outcomes in patients with COVID-19 patients at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia. Methods We conducted a single-centered descriptive study of adult COVID-19 patients hospitalized between March 1 and December 31, 2020, at KAUH. Patients were classified according to body mass index (BMI) as overweight (BMI 25-29.9 kg/m2) or obese (BMI ≥30 kg/m2). The main outcomes were admission to the intensive care unit (ICU), intubation, and death. Results Data were analyzed from 300 COVID-19 patients. Most study participants were overweight (61.8%), and 38.2% were obese. The most significant comorbidities were diabetes (46.8%) and hypertension (41.9%). Both hospital mortality (10.4% for obese; 3.8% for overweight, p = 0.021) and intubation rates (34.6% for obese; 22.7% for overweight, p = 0.004) were significantly higher among obese patients than overweight patients. There was no significant difference in terms of ICU admission rate between both groups. However, intubation rates (34.6% for obese; 22.7% for overweight, p = 0.004) and hospital mortality (10.4% for obese; 3.8% for overweight, p = 0.021) were significantly higher among obese patients than overweight patients. Conclusions This study aimed to describe the effect of high BMI on the clinical outcome of COVID-19 patients in Saudi Arabia. Obesity is significantly correlated with poor clinical outcomes in COVID-19. It is also associated with higher mortality and the need for mechanical ventilation necessitating intensive care unit admission. Patients with higher BMI should be prioritized in the hospital setting, as they have a higher potential of developing severe COVID-19 complications and sequelae.

Effect of Peer-Assisted Learning on Enhancing Clinical Research Skills Among Medical Students: Students' and Tutors' Perceptions.

PURPOSE: Research methodology is an essential part of evidence-based medicine. Many educational programs include clinical research methodology within their curriculum. Moreover, students' preferences for learning methods are different than before, as they now prefer alternative methods, such as peer teaching. Peer-assisted learning enhances students' tutoring skills. Thus, the current study aimed to evaluate the effect of peer teaching on enhancing clinical research skills. PARTICIPANTS AND METHODS: Peer-assisted learning was evaluated during a four-week online research methodology course designed for medical students at King Abdulaziz University. A total of 121 students' and 38 tutors' attitudes and perceptions of peer teaching were evaluated using a self-administered questionnaire. The effectiveness of peer teaching was assessed using pre- and post-course knowledge tests. Chi-square was used to assess the association of qualitative data, and Mann-Whitney U-test and Wilcoxon rank test were used as nonparametric tests for the variables that were not normally distributed. RESULTS: The post-course knowledge score was significantly higher than the pre-test score. Students had a positive perception of peer-assisted learning. Over 90% of the students preferred peer-assisted learning to traditional teaching. Similarly, the tutors had significantly positive perceptions of peer-assisted teaching. Younger students who had higher post-test mean knowledge scores had a good perception of peer teaching. CONCLUSION: The current study demonstrates students' and tutors' positive perceptions of peer-assisted learning as well as the effectiveness of peer learning. Medical schools should pay more attention to students and prepare them for peer-teacher roles.

Immediate intravenous epinephrine versus early intravenous epinephrine for in-hospital cardiopulmonary arrest.

BACKGROUND: Intravenous epinephrine has been a key treatment in cardiopulmonary arrest since the early 1960s. The ideal timing for the first dose of epinephrinee is uncertain. We aimed to investigate the association of immediate epinephrine administration (within 1-min of recognition of cardiac arrest) with return of spontaneous circulation (ROSC) up to 24-h. METHODS: This was a multicenter retrospective analysis of patients who underwent cardiopulmonary resuscitation. We included the following patients: 1) ≥18 years-old, 2) non-shockable rhythms, 3) received intravenous epinephrine during cardiopulmonary resuscitation, 4) witnessed in-hospital arrest and 5) first resuscitation attempt (for patients requiring more than one resuscitation attempt). We excluded patients who suffered from traumatic arrest, were pregnant, had shockable rhythms, arrested in the operating room, with Do-Not-Resuscitate (DNR) order, and patient aged 17 years-old or less. RESULTS: A total of 360 patients were included in the analysis. Median age was 62 years old and median epinephrine administration time was two minutes. We found that immediate epinephrine administration (within 1-min) is associated with higher rates of ROSC up to 24-h (OR = 1.25, 95% CI; [1.01-1.56]), compared with early epinephrine (≥2-min) administration. After adjusting for confounding covariates, earlier administration of epinephrine predicted higher rates of ROSC sustained for up to 24-h (OR 1.33 95%CI [1.13-1.55]). CONCLUSIONS: Immediate administration of epinephrine in conjunction with high-quality CPR is associated with higher rates of ROSC.

Response to Hydroxyurea in a Patient With Sickle Cell Hepatopathy: A Case Report.

Sickle cell hepatopathy is an underreported entity lacking clear management guidelines. This case highlights the potential role of hydroxyurea (HU) in improving the hepatic dysfunction seen among patients with sickle cell disease (SCD). We herein present the clinical course of a patient prior to and after the initiation of hydroxyurea with an emphasis on long-term outcomes and the patterns of liver injury over a 15-year time course.

The association of stress with sleep quality among medical students at King Abdulaziz University.

OBJECTIVE: This study aims to determine the prevalence and the association of stress with sleep quality among medical students at King Abdulaziz University (KAU), Jeddah, Saudi Arabia. METHODS: A cross-sectional study was done among 326 medical students of KAU using a stratified random sampling technique. An electronic self-administered questionnaire was used. Kessler Psychological Distress Scale (K10) and Pittsburgh Sleep Quality Index (PSQI) were used to assess the stress and sleep quality, respectively. RESULTS: The overall students who experienced stress were 65%. The prevalence of poor sleep quality (total PSQI score ≥5) was 76.4%. There was a strong association between stress and poor sleep quality (value of Cramer's V = 0.371, P < 0.001), and it showed that the increase in stress level is a significant predictor of poor sleep quality. CONCLUSION: A high prevalence of stress and poor sleep quality was found among the students and the study confirms a strong association between them. We recommend establishing courses focusing on educating the students about proper sleep hygiene and how to deal with the stressful environment.

Factors Influencing Saudi Medical Student's Decision Towards Cardiothoracic Surgery as a Future Career, a Cross Sectional Study.

INTRODUCTION: There has been a progressive decline in students' interest to consider cardiothoracic surgery as future career in the distant regions in the world. There are many factors could explain declining interest in cardiothoracic surgery including diminished caseloads due to the expansive growth of interventional cardiology; length of training programs that influences medical student's perception. King Abdulaziz University student's interest to join the speciality explored in our study. We determined some factors that influence their decision making toward their cardiothoracic career. AIM: We aimed to estimate the current interests of medical students at King Abdulaziz University to pursue a career in Cardiothoracic surgery and to determine the factors that positively or negatively affect their decision. MATERIAL AND METHODS: A self-administered online survey designed on Google form was distributed through email to fourth, fifth, and sixth-year medical students. Five domains; demographics, current career intentions, previous exposure to surgery, experiences and perceptions of cardiothoracic surgery were covered in the questionnaire to identify factors affecting student decision to choose cardiothoracic surgery as a future career. RESULTS: Among 486 students at our institution, 179 (36, 83%) medical students completed the questionnaire more than half of them 91 (50.8%) were males. The percentage of students who considered cardiothoracic surgery as a future career was (4.5%); when asked if they were serious in pursuing a career in cardiothoracic surgery, (14.5%) of the student were affirmative. Of those participated in the survey, Twenty-four students believed they had adequate introduction to the cardiothoracic surgery during their undergraduate program. CONCLUSION: cardiothoracic surgery is falling away behind other specialties as career of choice for many future physicians. It is believed mainly related to inadequate introduction to the field. Increasing exposure and close mentorship is needed to attract more students to pursue a career in cardiothoracic surgery.