Colostrum knowledge among Saudi mothers in Jeddah, Saudi Arabia.

OBJECTIVE: To assess the knowledge level of Saudi women about colostrum for the newborns. METHODS: The cross-sectional study was conducted from October 2015 to June 2016 at the Gynaecological Clinics of King Abdulaziz University Hospital, Jeddah, Saudi Arabia and comprised lactating mothers in the community. Data was collected using a pretested questionnaire. Data was analysed using SPSS 22. RESULTS: Of the 552 mothers, 301(54.5%) were age >30 years. The source of information about colostrum was friends and family for 367(66.67%) subjects. Overall, 367(66%) had high knowledge about colostrum. A significant correlation was detected between age and knowledge about colostrum composition and duration (p<0.05); as well as between educational level and colostrum composition, colour and form (p<0.05). A significant association between occupational status and knowledge about colostrum colour and form was also noted (p<0.05). CONCLUSIONS: Saudi mothers were found to have a good knowledge about colostrum and its benefits.

Autoimmune hemolytic anemia and ovarian dermoid cysts in pregnancy.

Ovarian teratoma is a rare cause of autoimmune hemolytic anemia (AIHA) by warm antibodies, resistant to corticosteroid therapy. This also implies that ovarian teratoma should be included in the differential diagnosis of AIHA, whether or not associated with pregnancy. We present a case of a primigravida who presented with ovarian dermoid cysts and AIHA at 24 weeks of gestation. The patient received corticosteroids, intravenous immunoglobulin, rituximab, and multiple blood transfusions, with no significant improvement. Hemoglobin levels returned to normal only after laparoscopic ovarian cystectomy. Autoimmune hemolytic anemia caused by dermoid cyst is a rare condition especially in pregnancy. However, in light of similar case reports and review of the existing literature, we conclude that surgical excision should be considered when AIHA and ovarian teratoma coexist.

Perceptions of medical students towards antibiotic prescribing for upper respiratory tract infections in Saudi Arabia.

INTRODUCTION: This survey evaluates knowledge, attitudes and practices of medical students towards use of antibiotics for upper respiratory infections (URTIs). METHODOLOGY: Cross-sectional questionnaire study among 1042 randomly selected medical students in Saudi Arabia. RESULTS: Respondents were mostly Saudis (97.5%), had previous knowledge of antibiotics (99.7%) and their usage (98.3%) against bacterial infections (93.7%). 18.1% thought that they could be used for viral infections. Nearly all students (97.2%) used antibiotics themselves during the previous year and self-medication without a prescription was high at 49% of cases. Most antibiotics were taken for URTI symptoms (61.8%). Female medical students had better knowledge on antibiotic effectiveness against bacteria and viruses, and overall knowledge increased with study year. Health seeking behaviour rates for symptoms of RTI and associated estimated necessity for antibiotics varied but were highest for cough with yellow/green phlegm. CONCLUSIONS: The depth of knowledge that healthcare professionals have in relation to the proper use of antibiotics is essential in spreading the right message within communities. This is the first large study among medical students in Saudi Arabia, shedding important light on areas for improvement in the medical curriculum as well as antibiotic practices of medical students themselves.

Prognostic value of mammographic breast density in patients with metastatic breast cancer.

Breast density is a modifiable trait linked with breast cancer predisposition. However, the relation between mammographic breast density and survival outcome is not yet clarified. The present study aims to study the prognostic value of mammographic density in patients diagnosed with metastatic breast cancer. In this observational study, breast cancer patients with metastatic disease at diagnosis were enrolled. Two-view mammograms were performed at diagnosis, and breast density was quantitatively assessed. Progression-free survival (PFS) was correlated with breast density and other prognostic variables in univariate and multivariate analyses. PFS, stratified by different prognostic factors, was assessed in low compared to high density patients to check for possible differential survival outcome in patients' subgroups. Among the sixty enrolled patients, median PFS in low density patients was significantly better than those with high density (18.4 months, 95 % CI 14.88-22.15 vs. 9.3 months, 95 % CI 8.51-13.60, respectively, p = 0.002). Significant correlation of breast density with PFS persisted after adjustment by body mass index (p = 0.003) and after multivariate analysis incorporating other prognostic variables (HR 6.16, 95 % CI (2.17-17.48), p = 0.001). PFS was better in low density patients older than 40 years at diagnosis (p = 0.001), with HER2-negative disease (p = 0.015), hormonal receptor-positive phenotype (p = 0.020), patients with single site of metastasis (p = 0.006), and patients with bone-only metastases (p = 0.042). Breast density assessed at the time of diagnosis was significantly correlated with PFS of metastatic breast cancer patients. Survival outcome is improved in certain patients' subgroups with low breast density.