Partial protection of Sinopharm vaccine against SARS COV2 during recent outbreak in Bahrain.

BACKGROUND: In order to impart immunity against SARS COV 2 in the community, the oil rich countries of the Gulf Cooperation Council (GCC) provided citizens and expatriates with free vaccination. Different types of vaccination brands were utilized for this purpose. The purpose of this study is to determine the efficacy of the different types of vaccinations used. METHODS: This is an observational analytical case study of one Bahraini family who were vaccinated with 1st, 2nd or no dose. RESULTS: Out of 22 double dose recipients of SARS COV2 vaccine, 20 were infected. Those 20 were vaccinated against SARS COV 2 using Sinopharm, the rest (2) were in direct contact with the source but were vaccinated against SARS COV 2 using other type of vaccine. Out of 26 single dose recipients of Sinopharm vaccine, 23 were infected. The other three were not in direct contact with the infected source. Social gathering has been the main source of transmission. The infection has been mild with headache, chest pain. From 20 cases with double dose vaccinations only one had a lung infection and needed hospitalization. Out of 23 cases with single dose vaccinations 10 were hospitalized due to lung infections. All family members who were not vaccinated were infected, three were hospitalized one of which was deceased due to diabetes mellitus complications. CONLCUSION: Sinopharm provides partial protection against SARS COV 2 infection. That might be due to lack of its potential to detect recent variations in the protein structure of spike(S) protein of virus.

Effects of Turmeric on Cardiovascular Risk Factors, Mental Health, and Serum Homocysteine in Overweight, Obese Females.

CONTEXT: The prevalence of overweight and obesity and associated comorbidities has progressively risen. Curcumin, the active ingredient in turmeric, and turmeric aqueous extract, a concentrated form, have been reported to have beneficial effects in treatment of cardiovascular diseases and their risk factors. However, turmeric has not been studied in its natural form. OBJECTIVE: The present study planned to evaluate the beneficial effects of turmeric in its natural form on obesity-related, cardiovascular-disease risk factors in overweight or obese females. DESIGN: The study used a pre-post, single-arm design. SETTING: The study took place in the Department of Physiology at Imam Abdulrahman Bin Faisal University (Dammam, Saudi Arabia). PARTICIPANTS: The participants were 36 young female students at the university, with a body mass index ≥ 23 kg/m2. INTERVENTION: Participants received a daily dose of 2 g/d of turmeric in capsules for 90 d. OUTCOME MEASURES: Anthropometric measures, blood pressure, serum homocysteine, and mental health status- stress, anxiety, depression scores-were recorded at baseline and postintervention. Dietary intake and physical activity (confounding variables) were also measured. RESULTS: The following anthropometric measures were reduced significantly between baseline and postintervention: (1) body weight-73.47 vs 72.45 kg (P = .04), (2) body mass index-28.75 vs 28.27 kg/m2 (P = .02), (3) waist circumference-81.85 vs 77.96 cm (P = .01), (4) hip circumference-102.72 vs 98.10 cm (P = .001), (5) body fat %-34.34 vs 32.58 (P = .00), (6) systolic blood pressure-119.12 vs 115.92 mm Hg (P = .04), and (7) anxiety scores-7.88 vs 4.73 (P = .03), as compared by paired t test. Homocysteine levels and stress and depression scores showed no significant changes. Dietary intake and physical activity did not vary significantly throughout the study period. CONCLUSION: Turmeric has the ability to reduce weight, decrease body fat percentage, lower systolic blood pressure, and relieve anxiety for young, obese and overweight females, when given at 2 g/d for 90 d.

Prevalence of primary dysmenorrhea and its relationship with body mass index.

AIM: To identify the association between primary dysmenorrhea (PD) and body mass index (BMI). METHODS: This cross sectional study was conducted on 370 female students (aged 18-25 years) of Immam Abdulrahman Bin Faisal University Dammam, from March 2016 till March 2017. Pretested dysmenorrhea questionnaire was filled by the students. Weight and heights of the subjects were measured, and BMI was calculated. Based on BMI, subjects were divided into four groups (underweight [UW], normal weight, overweight and obese [OB]). Subjects were also categorized into mild, moderate and severe dysmenorrhic groups based on numeric pain relating scale. SPSS version 20.0 was used to analyze the data. RESULTS: This study showed that 85.7% of the students were suffering from PD, out of which 12.7% had mild, 65.6% had moderate and 8.4% had severe dysmenorrhea. In total, 54.5% of the students mentioned that dysmenorrhea interferes with their daily activities. Whereas 55.8% of the students mentioned that they got pain relief by using non-steroidal anti-inflammatory drugs. Pair wise comparison of dysmenorrhea between different BMI groups showed a statistically significant difference in the frequency of moderate and severe dysmenorrhea between UW and OB subjects (P values 0.003 and 0.06) respectively, indicating that UW females are at a higher risk of having PD. CONCLUSION: This study indicates a higher prevalence of moderate and severe dysmenorrhea in UW as compared to the OB subjects. We recommend further studies to explore the underlying pathophysiological mechanisms responsible for this association.

Multi-class deep learning architecture for classifying lung diseases from chest X-Ray and CT images.

Medical imaging is considered a suitable alternative testing method for the detection of lung diseases. Many researchers have been working to develop various detection methods that have aided in the prevention of lung diseases. To better understand the condition of the lung disease infection, chest X-Ray and CT scans are utilized to check the disease's spread throughout the lungs. This study proposes an automated system for the detection multi lung diseases in X-Ray and CT scans. A customized convolutional neural network (CNN) and two pre-trained deep learning models with a new image enhancement model are proposed for image classification. The proposed lung disease detection comprises two main steps: pre-processing, and deep learning classification. The new image enhancement algorithm is developed in the pre-processing step using k-symbol Lerch transcendent functions model which enhancement images based on image pixel probability. While, in the classification step, the customized CNN architecture and two pre-trained CNN models Alex Net, and VGG16Net are developed. The proposed approach was tested on publicly available image datasets (CT, and X-Ray image dataset), and the results showed classification accuracy, sensitivity, and specificity of 98.60%, 98.40%, and 98.50% for the X-Ray image dataset, respectively, and 98.80%, 98.50%, 98.40% for the CT scans dataset, respectively. Overall, the obtained results highlight the advantages of the image enhancement model as a first step in processing.

Do Mock Medical Licensure Exams Improve Performance of Graduates? Experience from a Saudi Medical College.

Background: All medical graduates in Saudi Arabia are required to pass a Saudi Medical Licensure Exam (SMLE) to be able to practice and/or enroll in postgraduate training. Mock exams are a useful preparatory tool, but no study from Saudi Arabia has assessed its impact on performance in the actual licensure examinations. Objectives: To evaluate the impact of a series of mock SMLEs with immediate personalized feedback on graduate scores and their performance in the actual SMLE. Methods: This retrospective study included medical students who graduated in the 2019-20 academic year from Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia, and undertook mock SMLE exams offered in August 2020. Three mock exams were constructed using the SMLE blueprint and were offered to graduates 1 week apart. Immediately after each exam, a personalized learning outcomes achievement report was sent to each graduate. Exam reliability was measured by the Kuder-Richardson formula, and were 87%, 94%, and 96% for the first, second, and third exam, respectively. Results: A total of 71, 70, and 61 students completed the first, second, and third exams, respectively. Across the three mock exams, the mean (±SD) score showed an increasing trend, from 87.6 (±33.4; range: 28-191) in the first test to 93.5 (±45.6, range 15-204) in the second and 96 (±42.6; range: 25-203) in the third. Forty graduates completed all three mock exams; of these, the scores of 25 (62.5%) students significantly improved in both the second and third exams compared to the prior test (P = 0.002). A nonsignificant positive correlation was found between the average mock and the actual SMLE scores for whom data were available (r = 0.29; P = 0.27). Conclusion: The performance of graduates improved in subsequent mock exams, and there was a nonsignificant positive correlation between the mock and actual SMLE exam results. This study presents the usefulness of using mock exams as a preparatory tool for licensure examinations in Saudi Arabia.

Medical students' perception of professionalism: a qualitative study from Saudi Arabia.

BACKGROUND: Professionalism has emerged as a core competency for the medical professionals globally. However, few studies have been reported from the Gulf region to assess the situation and take steps to promote professionalism. AIM: To elicit the views of final year medical students, interns, and residents to explore what professionalism meant to them, what problems they encountered, and what can be done to promote professionalism. METHOD: We adopted qualitative approach including 10 focus group discussions. The proceedings were tape-recorded, transcribed, and analyzed independently by two researchers. RESULTS: The respondents admitted that that they were deficient in the acquisition of professional values. According to them, professionalism was not taught or assessed. They followed "hidden curriculum". They considered very few teachers as positive role models. The deficiencies could be attributed to negative role modeling by the faculty or deficiencies in the curriculum such as lack of rich clinical experiences, limited interaction with health team, and absence of feedback besides organizational issues. CONCLUSION: The students' views should be tallied with other sources of evidences. Nevertheless, they have policy implications on faculty recruitment, development, curriculum reform, and an organizational culture that supports professionalism.

The Efficacy and Safety of Liraglutide 3.0 mg for Weight Management in Obese Non-Diabetic Saudi Outpatients.

BACKGROUND: Unmanaged cases of obesity might lead to serious conditions and complications, which impair patients' lives. The aim of this study was to assess the effectiveness and safety of daily 3 mg subcutaneous (s/c) Liraglutide amongst obese non-diabetic patients in Eastern Province, Saudi Arabia. METHODS: A retrospective cohort study of obese non-diabetic Saudi patients with obesity managed with s/c Liraglutide 3.0 mg who visited the outpatient clinic in Al Mashfa Hospital, Al Khobar, KSA during 2019-2021. We collected patient data from the electronic reporting system for different parameters. Body weight, hemoglobin A1c %, systolic and diastolic blood pressure mmHg were obtained at baseline and after the intervention. RESULTS: Records of 258 patients who were using a daily dose of Liraglutide 3.0 mg s/c for at least four months have been reviewed. The body weight loss of patients who used Liraglutide for four months was 8.1±0.8 kg. Moreover, around 204 patients continued for up to six months. Meanwhile, the mean body weight loss was 13 kg. There was a significant reduction of hemoglobin A1c (HbA1c) % by 0.43%. The majority of patients (94.5%) reported satisfaction with the treatment, while adverse events were mainly nausea, vomiting and constipation. CONCLUSION: Daily s/c Liraglutide of 3.0 mg is effective in producing significant body weight reduction in obese non-diabetic Saudi patients with tolerable minimal side effects and may provide health benefits in terms of reduced risk of obesity and its related outcomes.

The need for national medical licensing examination in Saudi Arabia.

BACKGROUND: Medical education in Saudi Arabia is facing multiple challenges, including the rapid increase in the number of medical schools over a short period of time, the influx of foreign medical graduates to work in Saudi Arabia, the award of scholarships to hundreds of students to study medicine in various countries, and the absence of published national guidelines for minimal acceptable competencies of a medical graduate. DISCUSSION: We are arguing for the need for a Saudi national medical licensing examination that consists of two parts: Part I (Written) which tests the basic science and clinical knowledge and Part II (Objective Structured Clinical Examination) which tests the clinical skills and attitudes. We propose this examination to be mandated as a licensure requirement for practicing medicine in Saudi Arabia. CONCLUSION: The driving and hindering forces as well as the strengths and weaknesses of implementing the licensing examination are discussed in details in this debate.

Prevalence of menstrual problems and their association with psychological stress in young female students studying health sciences.

OBJECTIVES: To identify the prevalence of various menstrual problems in young females studying health sciences and to identify their association with academic stress. Methods: This was a cross-sectional study, conducted in the health colleges of Immam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia between February 2015 and February 2016. Seven hundred and thirty-eight female students aged 18-25 years anonymously completed menstrual problem identification and perceived stress scale questionnaire. The data was analyzed using the Statistical Package for Social Sciences version 16.0.  Results: Ninety-one percent of the students were suffering from some kind of menstrual problem. The different menstrual problems reported, and their incidences included irregular menstruation (27%), abnormal vaginal bleeding (9.3%), amenorrhea (9.2%),  menorrhagia (3.4%), dysmenorrhea (89.7%), and premenstrual symptoms (46.7%). High perceived stress (HPS) was identified in 39% of the students. A significant positive correlation was found between HPS and menstrual problems. Students with HPS had 4 times, 2 times, and 2.8 times increased odds ratio for experiencing amenorrhea, dysmenorrhea, and premenstrual syndrome (p less than 0.05).  Conclusion: The most prevalent menstrual problems (dysmenorrhea and premenstrual symptoms) in the target population were strongly associated with stress. Therefore, it is recommended that health science students should be provided with early psychological and gynecological counselling to prevent future complications.

Student and Faculty Perception of Objective Structured Clinical Examination: A Teaching Hospital Experience.

INTRODUCTION: The primary objective of this study was to explore student and faculty perception of the objective structured clinical examination (OSCE) to assess the clinical competence of 5th year medical students. METHODS: Two validated tools were used to survey students' and faculty perception of the OSCE as an assessment tool. The questionnaires were self-administered and handed to the students immediately after the OSCE was conducted. Subjects were 29 female students who had completed their 3-week Internal Medicine rotation and 15 faculty members who had participated in evaluating the students. The response rate was 100%. The OSCE comprised of 21 active stations involving skills like history taking standardized patients were used, physical examination, and data interpretation for which real patients were used, physical examination, or management. Standardized or real patients were used in 16 stations. RESULTS: Majority of students, 63.2% indicated that the OSCE assessed their skills fairly. This was also true for 80% thought the OSCE was a fair method of assessing students' skills as well as a better assessment tool than the traditional long/short case exams. CONCLUSION: The OSCE was positively perceived by 5th year medical students and faculty members as a tool that can fairly assess students' clinical skills.

The Determinants of Leptin Levels in Diabetic and Nondiabetic Saudi Males.

Objective. This study aimed to identify the main determinants of serum leptin levels. Methods. A sample of 113 Saudi adult males (55 diabetic and 58 nondiabetic) was selected according to the inclusion and exclusion criteria identified below. Blood samples were taken from participants after fasting for 12 hours. For diabetic patients, the insulin dose was given 12 hours before. In general, the study instrument consisted of blood biochemical tests. Metabolic parameters, glycosylated hemoglobin (HbA1c), low-density lipoprotein (LDL), high-density lipoprotein (HDL), cholesterol, and triglyceride (TG), and adipokines, leptin, adiponectin, visfatin, and resistin, were measured. Multivariate model was utilized to identify the relationship between leptin levels and the independent variables. Results. When adjusted for resistin in the diabetic group, the results demonstrated a significant relationship between visfatin, LDL and TG, and leptin levels (p < 0.05). However, when controlled for resistin, the effect of LDL and TG disappeared while that of visfatin stayed in the model. For the nondiabetic group, the results indicated a significant relationship between insulin, BMI, and leptin levels when adjusted for resistin (p < 0.05). However, the effect of insulin disappeared when the model was controlled for resistin. The study results found no relationship between leptin and adiponectin levels in either the diabetic or nondiabetic group and whether adjusted or controlled for resistin. Conclusion. This study provided better understanding of the metabolism of leptin and unveiled the major determinants of leptin levels in diabetic and nondiabetic males. In conclusion, these results show that the association between leptin and metabolic parameters decreases with the progress of disease.

Is Cronbach's alpha sufficient for assessing the reliability of the OSCE for an internal medicine course?

BACKGROUND: The number of medical students accepted into medical programs is increasing, which has made the traditional long/short case style of examination difficult to conduct. At Dammam University, the program is shifting to the use of the Objective Structural Clinical Examination (OSCE), which may solve some of these difficulties, including issues with reliability, validity index and exam duration. RESULTS: A pilot study was conducted over one semester. A total of 207 examinees in three groups took the OSCE and written exams. The OSCE consisted of 18 clinical stations and required 3-4.3 h/day. The written exam contained 80 multiple-choice questions. The Cronbach's alpha for each group was 0.7, 0.8, and 0.9. Correlations for all stations ranged from 0.7 to 0.8, which indicated good stability and internal consistency with minor differences in the progression of the indexes. The reliability of the written exam was 0.79, and the validity of the OSCE was 0.63, as assessed using Pearson's correlation. CONCLUSION: No single reliability index can be considered a perfect assessment tool to solve this issue. Thus, at least two to three indexes should be used to ensure the reliability of the OSCE.

Assessment of educational environment of surgical theatre at a teaching hospital of a saudi university: using surgical theatre educational environment measures.

OBJECTIVES: This study was aimed to determine how medical interns perceive the important factors of the learning environment the surgical theatre at the teaching hospital of the medical school, University of Dammam (UoD). The study also investigated the relationships between the learning environment and academic achievements. Finally, it determined the role and significance of gender on the above perceptions and relationships. METHODS: The Surgical Theatre Educational Environment Measure (STEEM) was used to identify the perceptions of interns on the most important factors prevalent in the surgical theatre as an educational environment. STEEM was administered to all interns during the period of June-September 2009. Ninety-one out of 145 students completed the questionnaire representing a response rate of 63%. Non-parametric statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) Version 17. RESULTS: The STEEM was shown to be internally consistent for the assessment of the overall educational environment in the surgical theatre of UoD. The overall STEEM mean score was 110. For male and female students, the mean scores were 114 and 107 respectively. There were statistically significant gender differences in the perceptions of "learning opportunities" and "teaching and training". Females rated these subscales lower than males. There were no significant associations between academic achievements and perceptions of the educational environment. CONCLUSION: The interns perceived the learning environment of the surgical theatre as less than satisfactory. In comparison with the males; the perception of the females was less positive, particularly in the areas of learning opportunities, and teaching and training. The study also revealed some other problematic areas in the learning environment of surgical theatre of the teaching hospital of UoD. The results imply that there is much room for improvement. They also indicate that equal opportunities for learning and training should be given to both sexes.

Effect of stress on pain perception in young women.

OBJECTIVE: To determine the effect of physical and mental stressors on pressure pain threshold (PPT), and pressure pain tolerance (PTOL) values, and to compare these different types of stressors on its ability to affect PPT and PTOL values in young women. We also correlated body mass index (BMI) with PPT and PTOL in young women. METHODS: This was a self-controlled study carried out on 79 second-year female medical students in the Department of Physiology, King Faisal University, Dammam, Saudi Arabia during the year 2007. The students were assessed before, and after they were subjected to a mental (exam), and 2 physical stressors. Measurements of PPT and PTOL were carried out using a pressure algometer. The 2 physical stressors used were: cold water immersion and isometric exercise (ISO EX) with a dynamometer. Students' body mass indices were measured in addition to the measurement of blood pressure and heart rate for each student before, and after exposure to the stressors. RESULTS: All 3 stressors significantly increased the PPT values (p=0.000). The PTOL was also significantly increased immediately after exposure to the physical stressors (p=0.000), while for the mental stressor, the PTOL readings were not significantly increased. Among the 3 types of stressors, the cold water immersion was the most effective in increasing PPT and PTOL. Moreover, a significant (p=0.009) negative correlation was demonstrated between the BMI and PTOL readings. CONCLUSION: Various types of physical and mental stressors significantly increased PPT and PTOL readings in young female adults, in addition to the significant findings that students with higher body mass indices tolerated pain less.