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Background/aim: cognitive flexibility refers to people’s capacity to change or evolve their thinking and strategies when confronted with new information or circumstances These attributes are essential in research environments where complex and dynamic challenges frequently arise. In this study, the aim is to explore and establish whether a correlation exists between cognitive flexibility and research performance, especially in the medical students, in order to fill the deficit, if any, as well as understand the status of research teaching. Methods: We conducted an analytical cross-sectional study with medical students from the College of Medicine at King Saud University in Riyadh, Saudi Arabia. We requested the subjects to participate in an online questionnaire consisting of four question sections. They included demographic information, a Cognitive Flexibility Scale, knowledge, attitude, practice, and barriers to performing medical research. Results: The survey received responses from 303 medical students. We judged cognitive flexibility highest in the willingness to shift to possible alternatives and lowest in the use of acquired knowledge in practical contexts. The students were aware of and had a positive attitude towards research, although only 19.5% of them had actually published. Some of the barriers included inadequate time and challenges with follow-up care for patients. It was established that there was a weak negative relationship between the scores of perceived barriers and the Cognitive Flexibility score (r = -0.217, P < 0.001). Conclusion: The study has concluded that students with higher cognitive flexibility cope with the barriers better and, therefore, are likely to be in a better state of well-being. This suggests that the medical education system should include techniques like problem-based learning. Meanwhile, research efforts should aim to test more specific and accountable methods for enhancing cognitive flexibility, as well as their impact on learning and clinical practice. Clinical trial number: Not applicable. [ABSTRACT FROM AUTHOR]

Cardiac myxoma is considered the most common primary cardiac tumor and has been reported to cause different neurological complications through distinctive mechanisms, including pseudovasculitis. Herein, we present and review a case of a young male with a previous history of ischemic stroke who presented with multiple territorial ischemic insults in the presence of a presumed diagnosis of vasculitis. Once further workup was done, he was found to have a left atrial myxoma. [ABSTRACT FROM AUTHOR]

Background: Gastroesophageal reflux disease (GERD) is a common chronic digestive disease that affects people in different communities at different rates. Because of the absence of a validated Arabic tool to assess GERD symptoms, this study aimed to validate and culturally adapt the GERD questionnaire (GerdQ) tool to Arabic speakers. Methods: Patients referred for pH testing with symptoms suggestive of GERD were recruited. A cross-sectional study was conducted from March 2023 to April 2023 by administering the Arabic GERD questionnaire (Ar-GerdQ) tool on two different occasions and comparing it with the short-form leeds dyspepsia questionnaire and the Reflux Symptom Index to establish reliability and construct validity. Results: A total of 52 participants were included in the study. The results of the internal consistency analysis of the Ar-GerdQ indicate that the test has good reliability, with a Cronbach's alpha coefficient of 0.86 (95% CI: 0.75–0.91). Significant positive correlations with the short form leeds dyspepsia questionnaire (r = 0.59, P < 0.001, 95% CI: 0.29–0.78) and the reflux symptom index (r = 0.47, P = 0.01, 95% CI: 0.13–0.71) were demonstrated. Moreover, the intraclass correlation coefficient value was 0.60 (P < 0.001, 95% CI: 0.28–0.77), indicating a substantial level of agreement between the measurements. Conclusions: Our findings indicate that the Ar-GerdQ is useful for assessing reflux disease symptoms among Arabic speakers. Effective utilization of Ar-GerdQ will reduce unnecessary endoscopic requests in primary care settings. [ABSTRACT FROM AUTHOR]

Background/objectives: Cognitive flexibility is the mental skill that allows a person to shift between different ideas or concepts and think about several concepts simultaneously. A commonly used tool to assess cognitive flexibility is the Cognitive Flexibility Scale (CFS). This study focused on translating and validating the CFS into Arabic, given the lack of existing Arabic tools for assessing cognitive flexibility. Methods: Conducted at King Saud University, Riyadh, between April and June 2024, the study employed random sampling and involved 529 participants, including 419 students and 110 patients. Results: The average participant age was 25.8 years, with females making up 56.9% of the sample. Participants completed the Arabic CFS, along with the Emotion Regulation Questionnaire (ERQ) and the Perceived Stress Scale (PSS), at two time points 3–6 weeks apart. Reliability was evaluated through internal consistency (Cronbach's alpha = 0.8) and test–retest reliability (intraclass correlation coefficient = 0.82). Item analysis indicated that removing any single item did not significantly impact overall reliability, and inter-item correlations were strongest between items 4 and 6 (0.55) and items 6 and 7 (0.51). Validity was assessed through face, content, and construct validity, with factor analysis revealing a dominant single component accounting for 34.4% of the variance, confirming the scale's unidimensionality. Content validity indices for all items exceeded 0.9 in terms of relevance, importance, simplicity, and clarity. The Arabic CFS demonstrated good construct validity, showing significant correlations with the ERQ's reappraisal and suppression dimensions and the PSS. Conclusion: In conclusion, the Arabic version of the CFS is a valid and reliable tool for assessing cognitive flexibility in Arabic-speaking populations. This tool will be valuable in both clinical and research settings within Saudi Arabia, offering a robust instrument for evaluating cognitive flexibility. [ABSTRACT FROM AUTHOR]

Traveling physicians will likely be called for medical assistance on board. In-flight medical emergencies (IMEs) are common and occur in a complex environment with limited medical resources. This study evaluated senior medical students' willingness, understanding, confidence, and attitudes toward IMEs and their willingness to respond to them. This cross-sectional study was conducted among senior medical students in the College of Medicine, King Saud University, Riyadh, Saudi Arabia. These medical students were sent a self-administered online questionnaire, which consisted of basic demographic data, a survey to evaluate IME experiences, and a 10-item questionnaire to assess the attitude of students. Among 302 medical students, 52.3% were males, while 66.9% were over 22 years old. The prevalence of students who attended life support training was 62.6%, which was highly significant among the 5th-year level (p = 0.001). Neutral attitudes were found in most students (87.7%); 4.6% had positive attitudes, while 7.6% had negative ones. Being at the 5th-year level and having previous participation in life support training were associated with an increased attitude toward in-flight medical emergencies. The attitude of senior medical students toward IMEs was less than desired. However, the attitude was better among 5th-year medical students who attended training courses on managing IMEs. Thus, participation in training courses influenced the willingness to manage such cases. Subsequently, longitudinal studies are needed to extract more data on the knowledge and confidence of medical students toward IMEs. [ABSTRACT FROM AUTHOR]

Background: Isotretinoin is an effective treatment for acne but can cause side effects such as changes in blood lipids and liver enzymes. Laboratory monitoring is essential during treatment, but there is variation in monitoring practices. Aim: This study aims to investigate the relationship between isotretinoin therapy and its effects on complete blood count in Saudi Arabia to improve patient outcomes. Methods: The study was a retrospective cohort study conducted at King Khalid University Hospital in Riyadh, Saudi Arabia, between January 2016 and December 2020. Following the inclusion and exclusion criteria, 515 patients were randomly selected for the study. The data was analyzed using SPSS, and descriptive statistics and paired samples t-tests were employed to analyze the data. Results: In this study, 515 patients were enrolled. Of these participants, 76.7% (n=395) were females and 23.3% (n=120) were males. The mean age of the study participants was 23.98± 7.4 years and ranged between 16 and 65 years. The mean dose of Isotretinoin administered was 27.65± 9.6 mg/day, with a range of 10– 60 mg/day. The mean BMI of the study participants was 24.3± 4.1 kg/m2, ranging from 14.3 to 44.8 kg/m2. Regarding the effect of Isotretinoin on laboratory measures, significant statistical differences were found in hemoglobin measurements (t=− 3.379, p=0.001), platelets (t=− 3.169, p=0.002), neutrophils (%) (t=3.107, p=0.002), total cholesterol (t=− 13.017, p=0.000), AST (t=− 6.353, p=0.000), ALT (t=− 4.352, p=0.000), HDL (t=2.446, p=0.015), and LDL (t=− 12.943, p=0.000). However, there were no significant statistical differences in the measurements of WBC, neutrophils (count), or triglycerides. In the Chi-square analysis and Fisher's Exact test to identify the interaction between BMI, dose, and gender on abnormal lab results, significant interaction was found between participants' BMI and abnormal HDL measurements (p=0.006). Furthermore, there were significant interactions between Isotretinoin dose (either less than 30 mg/day or 30 mg/day or more) and abnormal neutrophil count (p=0.04), abnormal HDL measurements (p=0.010), and abnormal triglycerides measurements (p=0.020). Moreover, a statistically significant interaction was found between participants' gender and abnormal hemoglobin measurements (p=0.006), abnormal total cholesterol (p=0.016), abnormal AST measurements (p=0.001), abnormal ALT measurements (p=0.000), abnormal HDL measurements (p=0.000), and abnormal triglycerides measurements (p=0.007). Conclusion: In conclusion, the study found that isotretinoin therapy has significant effects on several laboratory measures, including hemoglobin, platelets, neutrophils, total cholesterol, AST, ALT, HDL, and LDL. The study also revealed significant interactions between BMI, dose, gender, and abnormal lab results. [ABSTRACT FROM AUTHOR]

As a result of the increasing global incidence of obesity and related diseases, this study aims to investigate the prevalence of obesity and its correlation with eating disorder (ED) screening among medical students to develop effective prevention strategies and provide better outcomes for these students. We conducted a quantitative analytical cross-sectional study at the College of Medicine at King Saud University between November 2023 and February 2024. A stratified random sampling technique was utilized, enrolling a net number of 415 participants. Participants were asked several questions, including demographic information, weight, height, and past medical history, and were given a validated screening tool for EDs. Participants' mean age was 21.4 ± 1.67 years, and 17.6% were considered obese. The prevalence of positive screening for EDs was 27.7%; it was more common in females (p = 0.013) and those who earned more than 1000 SAR per month (p = 0.011). Female students also exhibited almost twice the odds of having EDs than males (AOR = 1.957; 95% CI = 1.218–3.146; p = 0.006). Furthermore, non-obese students showed decreased odds of having EDs compared with obese students by at least 48% (AOR = 0.517; 95% CI = 0.287–0.929; p = 0.027). Our study revealed a concerning prevalence of ED symptoms and obesity among medical students, suggesting profound implications. Therefore, multicenter studies are needed to assess the generalizability of the results and apply the findings to targeted national campaigns and interventions tailored specifically to medical students. [ABSTRACT FROM AUTHOR]

Medial tibial stress syndrome (MTSS), commonly known as shin splints, is characterized by pain and inflammation in the shin caused by repetitive stress. While often associated with sports and physical activity, MTSS can significantly impact daily life, particularly in military recruits, making it a pertinent concern for this population. This narrative review synthesizes findings from a comprehensive search of databases to explore the prevalence, risk factors, and management of MTSS among military recruits. The search identified 35 studies discussing these aspects. MTSS is highly prevalent among military recruits, with an incidence ranging from 35% to 56%. Key risk factors include female sex, higher BMI, low aerobic fitness, smoking, and specific anatomical characteristics. Various treatments, including extracorporeal shockwave therapy (ESWT), compression therapy, pneumatic leg braces, and shock-absorbing insoles, have been shown to effectively accelerate recovery. Early identification of at-risk individuals could significantly reduce MTSS incidence and related healthcare costs. Emerging artificial intelligence tools also hold promise for delivering precise risk assessments. In conclusion, MTSS is a common issue among military personnel, driven by the physical demands of their training and specific risk factors. Further research into predictors of MTSS across diverse military populations is essential to improve outcomes., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Alessa et al.)