Anatomy e-Learning Experience in Saudi Arabia During the COVID-19 Pandemic - A Narrative Review / Experiencia de Aprendizaje Electrónico de Anatomía en Arabia Saudita Durante la Pandemia de COVID-19 - Una Revisión Narrativa

SUMMARY: Anatomy is a three-dimensional subject which needs face-to-face interaction and faced major challenges during the pandemic warranted changes in medical education. A narrative review was conducted to assess the attitude and perception of students and teaching faculty of healthcare professional courses towards Anatomy online teaching in the Kingdom of Saudi Arabia (KSA). A five stage framework narrative reviews outlined by Arksey & O'Malley (2005) was adopted for the current study. Inclusion criteria was studies conducted in Saudi Arabian healthcare professional colleges regarding online Anatomy teaching during the pandemic from March 2020 to April 2023. PRISMA-ScR search strategy was employed for identifying relevant studies which were managed using Endnote reference manager version 20. Nine articles were included in the review out of which two were mixed method studies, two were qualitative and five were quantitative studies. Students and teachers were mostly found to be satisfactory of the Anatomy e-learning experience. Major setbacks found were student and teaching faculty's negative attitude towards online practical teaching and concerns regarding academic dishonesty in students during online examination. Role of digital proficiency of teachers and students in the success of e-learning was emphasized by the review. This narrative review has mapped out the strengths and gaps in remote Anatomy teaching in Saudi Arabia during COVID-19 pandemic. There is a generally successful transition to e-learning in KSA from conventional teaching in Anatomy during the pandemic notwithstanding a few challenges that need to be addressed to improve the teaching and learning experience of Anatomy. Keywords: Anatomy, Online, E-learning, Saudi Arabia.

La anatomía es un tema tridimensional que necesita una interacción cara a cara y enfrentó grandes desafíos durante la pandemia, que justificó cambios en la educación médica. Se realizó una revisión narrativa para evaluar la actitud y la percepción de los estudiantes y profesores de cursos para profesionales de la salud, hacia la enseñanza en línea de Anatomía en el Reino de Arabia Saudita. Para el estudio actual, se adoptó una revisión narrativa del marco de cinco etapas delineada por Arksey & O'Malley (2005). Los criterios de inclusión fueron estudios realizados en colegios profesionales del área de la salud de Arabia Saudita, con respecto a la enseñanza de anatomía en línea durante la pandemia desde marzo de 2020 hasta abril de 2023. Se empleó la estrategia de búsqueda PRISMA-ScR para identificar estudios relevantes que se administraron utilizando el administrador de referencia Endnote versión 20. Se incluyeron nueve artículos en la revisión, de los cuales dos eran estudios de métodos mixtos, dos eran estudios cualitativos y cinco eran estudios cuantitativos. Se encontró que los estudiantes y profesores, en su mayoría estaban satisfechos con la experiencia de aprendizaje electrónico de Anatomía. Los principales contratiempos encontrados fueron la actitud negativa de los estudiantes y profesores hacia la enseñanza práctica en línea y las preocupaciones sobre la deshonestidad académica de los estudiantes durante los exámenes en línea. La revisión enfatizó el papel de la competencia digital de profesores y estudiantes en el éxito del aprendizaje electrónico. Esta revisión narrativa ha mapeado las fortalezas y brechas en la enseñanza remota de anatomía en Arabia Saudita, durante la pandemia de COVID-19. En general, hay una transición exitosa al aprendizaje electrónico en Arabia Saudita desde la enseñanza convencional de Anatomía durante la pandemia, a pesar de algunos desafíos que deben abordarse para mejorar la experiencia de enseñanza y aprendizaje de Anatomía.

Role of neuroinflammation mediated potential alterations in adult neurogenesis as a factor for neuropsychiatric symptoms in Post-Acute COVID-19 syndrome-A narrative review.

Persistence of symptoms beyond the initial 3 to 4 weeks after infection is defined as post-acute COVID-19 syndrome (PACS). A wide range of neuropsychiatric symptoms like anxiety, depression, post-traumatic stress disorder, sleep disorders and cognitive disturbances have been observed in PACS. The review was conducted based on PRISMA-S guidelines for literature search strategy for systematic reviews. A cytokine storm in COVID-19 may cause a breach in the blood brain barrier leading to cytokine and SARS-CoV-2 entry into the brain. This triggers an immune response in the brain by activating microglia, astrocytes, and other immune cells leading to neuroinflammation. Various inflammatory biomarkers like inflammatory cytokines, chemokines, acute phase proteins and adhesion molecules have been implicated in psychiatric disorders and play a major role in the precipitation of neuropsychiatric symptoms. Impaired adult neurogenesis has been linked with a variety of disorders like depression, anxiety, cognitive decline, and dementia. Persistence of neuroinflammation was observed in COVID-19 survivors 3 months after recovery. Chronic neuroinflammation alters adult neurogenesis with pro-inflammatory cytokines supressing anti-inflammatory cytokines and chemokines favouring adult neurogenesis. Based on the prevalence of neuropsychiatric symptoms/disorders in PACS, there is more possibility for a potential impairment in adult neurogenesis in COVID-19 survivors. This narrative review aims to discuss the various neuroinflammatory processes during PACS and its effect on adult neurogenesis.

Impact of COVID-19 outbreak on the mental health status of undergraduate medical students in a COVID-19 treating medical college: a prospective longitudinal study.

BACKGROUND: The COVID-19 pandemic is found to affect the mental health of the population. Undergraduate medical students are especially prone to mental health disorders and hence could be more vulnerable to the impact of the pandemic. METHODS: A prospective longitudinal study was conducted on 217 undergraduate medical students in a medical college at Chennai, India. Depression, anxiety, and stress levels were recorded using Depression Anxiety Stress Scale 21 Items (DASS21) before and during the COVID-19 outbreak in India in December 2019 and June 2020, respectively. In the follow-up survey, in addition to DASS21, the Pittsburgh Sleep Quality Index to assess sleep quality and a self-administered questionnaire to assess the impact of COVID-19 related stressors were used. The self-administered questionnaire assessed the status of COVID-19 testing, interactions with COVID-19 patients, self-perceived levels of concerns and worries related to academics (COVID-19-AA (academic apprehensions)) and those pertaining to the self and family/friends (COVID-19-GA (general apprehensions)). Cross-sectional and longitudinal comparison of overall scores of depression, anxiety, and stress and scores stratified by gender, year of study, place of residence and monthly family income were performed. Predictors for depression, anxiety, and stress during COVID-19 were investigated using adjusted binary logistic regression analysis and results were expressed as adjusted odds ratio with 95% confidence interval (CI). A P value < 0.05 was considered statistically significant. RESULTS: The average scores of depression, anxiety, and stress during the baseline survey were 7.55 ± 7.86, 4.6 ± 6.19 and 7.31 ± 7.34 with the prevalence (95% Cl) of 33.2% [27-39.9%], 21.2% [16-27.2%] and 20.7% [15.5-26.7%]; in follow-up survey, the mean scores were 8.16 ± 8.9, 6.11 ± 7.13 and 9.31 ± 8.18 with the prevalence being 35.5% [29.1-42.2%], 33.2% [27-39.9%] and 24.9% [19.3-31.2%] for depression, anxiety, and stress respectively. There was a significant increase in both the prevalence and levels of anxiety and stress (P < 0.001), with depression remaining unchanged during COVID-19, irrespective of gender, year of study, place of residence and family's monthly income. Poor sleep quality, higher levels of baseline depression, anxiety, and stress, higher COVID-19-GA, COVID-19 patients in family/friends and direct interactions with COVID-19 patients were found to be significant predictors of negative mental health in undergraduate medical students. COVID-19-AA was not significantly associated with depression, anxiety, and stress. CONCLUSION: The COVID-19 pandemic appears to negatively affect the mental health of the undergraduate medical students with the prevalence and levels of anxiety and stress being increased, and depression symptoms remaining unaltered. Addressing and mitigating the negative effect of COVID-19 on the mental health of this population is crucial.