Depression, anxiety and stress among medical and non-medical students in Saudi Arabia: An epidemiological comparative cross-sectional study.

OBJECTIVES: To quantify the extent and variation of depression, anxiety and stress among medical and non-medical Saudi Arabian students. METHODS: In this cross-sectional study, students from Umm Al-Qura University, Makkah, Saudi Arabia, were recruited. The Faculty of Education was randomly selected to represent the non-medical colleges. The depression, anxiety and stress scale-21 items (DASS-21) was used to estimate the study outcomes. RESULTS: Of the 465 undergraduates recruited in this study, 49.68% (n=231) were medical students and 50.32% (n=234) were non-medical students. Approximately 54%, 53%, and 38% of the participants were found to be suffering from depression, anxiety, and stress, respectively. The analyses showed that the two groups did not differ significantly with respect to stress and depression (p=0.934 and 0.423, respectively). However, the non-medical students exhibited a significantly higher anxiety score compared to the medical students (p=0.002). Family conflicts was a common risk factor for the studied psychological disturbances. Female gender and travel time from home to university were significant predictors of depression and anxiety, whereas a positive history of a psychological condition increased the likelihood of depression and stress. CONCLUSION: There was a high prevalence of anxiety, stress, and depression among the students, with a significantly higher anxiety levels among the non-medical students.

Developing an integrated organ/system curriculum with community-orientation for a new medical college in jazan, saudi arabia.

BACKGROUND: Jazan province is located in the south-west of the Kingdom of Saudi Arabia. The province is offlicted with a wide spectrum of diseases and therefore have a special need for more health services. The Faculty of Medicine at Jazan has been following the traditional curriculum since its inception in 2001. The traditional curriculum has been criticized because of the students inability to relate what they learned in the basic sciences to medicine, thus stifling their motivation. It was felt that much of what was presented in preclinical courses was irrelevant to what the doctor really needed to know for his practice. The College therefore, decided to change to an integrated curriculum. DESIGN: The study was conducted in 2004-2005 in the Faculty of Medicine, Jazan University. It began with a literature survey/search for relevant information and a series of meetings with experts from various institutions. A Curriculum Committee was formed and a set of guiding principles was prepared to help develop the new curriculum. A standard curriculum writing format was adopted for each module. It was decided that an independent evaluation of the new curriculum was to be done by experts in medical education before submission for official approval. There were several difficulties in the course of designing the curriculum, such as: provision of vertical integration, the lack of preparedness of faculty to teach an integrated curriculum, and difficulties inherent in setting a truly integrated examination. CURRICULUM: The program designed is for 6 years and in 3 phases; pre-med (year 1), organ/system (years 2 and 3), and clinical clerkship (years 4, 5, and 6). This is to be followed by a year of Internship. The pre-med phase aims at improving the students' English language and prepare them for the succeeding phases. The organ/ system phase includes the integrated systems and the introductory modules. The curriculum includes elective modules, early clinical training, behavioral sciences, medical ethics, biostatistics, computer practice, and research methods. The curriculum provides active methods of instruction that include: small group discussion/ tutorials, problem-based learning (PBL), case-study/ clinical presentations, seminars, skills practice (clinical skill lab), practical, demonstration, and student independent learning. Methods of evaluating students include continuous and summative assessment. CONCLUSION: The new curriculum adopted by the Jazan Faculty of Medicine is an integrated, organ/ system based, community-oriented, with early clinical skills, elective modules, and innovative methods of instructions.

Bone mineral density of the spine and femur in healthy Saudis.

The reference values of bone mineral density (BMD) were determined in healthy Saudis of both sexes and compared with US / northern European and other reference data. BMD was determined by dual-energy X-ray absorptiometry (DXA) at the lumbar spine and femur including subregions: trochanter, Ward's triangle, and neck, in 1,980 randomly selected Saudis (age range 20-79 years; 915 males and 1,065 females) living in the Jeddah area. Age-related changes in BMD were similar to those described in US / northern European and Lebanese reference data. Decreases in BMD of males were evident (% per year): 0.3-0.8 (lumbar spine), 0.2-0.4 (femoral trochanter), 0.2-1.4 (Ward's triangle), and 0.2-0.7 (femoral neck). Also, decreases in BMD of females were observed (% per year): 0.8-0.9 (lumbar spine), 0.7-0.9 (Ward's triangle), and 0.3-0.7 (femoral neck). Using stepwise multiple regressions that included both body weight and height, the former had 2-4 times greater effect on BMD than the latter. Using the mean BMD of the <35-year-old group the T-score values were calculated for Saudis. The prevalence of osteoporosis in Saudis (50-79 years) at the lumbar spine using the manufacturer's vs Saudi reference data was 38.3-47.7% vs 30.5-49.6 (P<0.000), respectively. Similarly, based on BMD of total femur, the prevalence of osteoporosis using the manufacturer's vs Saudi reference data was 6.3-7.8% vs 1.2-4.7% (P<0.000), respectively. Saudis (> or =50 years) in the lowest quartile of body weight exhibited higher prevalence of osteoporosis (25.6% in females and 15.5% in males) as compared to that of the highest quartiles (0.0% in females and 0.8% in males). The present study underscores the importance of using population-specific reference values for BMD measurements to avoid overdiagnosis and/or underdiagnosis of osteoporosis.

Role of magnesium sulphate in treatment of severe persistent pulmonary hypertension of the neoborn.

OBJECTIVE: Treatment of severe persistent pulmonary hypertension of the neoborn remains controversial and various modalities of treatment have been tried. This study was performed to evaluate the effect of magnesium sulphate (MgSO4) as a treatment of persistent pulmonary hypertension of the neoborn (PPHN) in full term babies. METHODS: This study was carried out in the Maternity and Children's Hospital, Jeddah, Kingdom of Saudi Arabia from January 1998 to 2000. A non-randomized study in 8 neoborn babies who where admitted to the Intensive Care Unit and diagnosis of PPHN based on echocardiogram was conducted to assess the efficacy of MgSO4 8% dilution in a loading dose of 200mg/kg followed by a maintenance dose of 20-100mg/kg/hour. No other vasodilators were given, patients were not hyperventilated. The aim was to keep magnesium levels 3.5-5.5mgmmol/l. RESULTS: Seven out of 8 patients showed marked improvement in partial pressure oxygen at 6 hours and maximum improvement at 24 hours. The same improvement noticed in peak inspiratory pressure, and ventilatory time support. CONCLUSION: Results suggests that MgSO4 may be considered as an alternative treatment in PPHN when no other modalities are available as it is a non aggressive and low cost treatment.

Education of female students in reproductive health issues in Jeddah: the role of school workers.

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