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Hebah Almulla,1 Asim Al-Ansari2 1Department of Fundamentals of Nursing, College of Nursing, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaCorrespondence: Hebah Almulla, Tel +1 966 13 333-1648, Email haalmulla@iau.edu.saBackground: The COVID-19 pandemic has affected the Saudi population despite early efforts taken by officials. This study aimed to describe the precautionary measures taken by patients prior to their diagnosis with COVID-19.Methods: A qualitative descriptive design was employed to collect data from a convenience sample of 26 participants who had COVID-19 and recovered. Data was collected through conducting telephone interviews and was then transcribed and analyzed using inductive content analysis methods adapted from grounded theory.Results: Data analysis yielded six categories of precautionary measures participants reported using to minimize their risk of contracting COVID-19: (1) wearing a mask, (2) staying at home and avoiding crowds, (3) washing hands and wearing gloves, (4) following social distancing, (5) using sanitizers, and (6) not interacting with anyone.Conclusion: The discrepancy found between the participants’ reported precautionary measures and their actual behavior, as well as the consistency and specificity with which they implemented some and not all measures raise concerns about existing public health messages. The study findings support the importance of well-structured and detailed communication when designing future public health campaigns and data-driven policies.Keywords: precautionary measures, COVID-19, qualitative, content analysis, Saudi Arabia

Mona Arekat,1 Mohamed Hany Shehata,2,3 Abdelhalim Deifalla,4,5 Ahmed Al-Ansari,6 Archana Kumar,6 Mohamed Alsenbesy,1,7 Hamdi Alshenawi,8 Amgad El-Agroudy,1 Mariwan Husni,9,10 Diaa Rizk,11 Abdelaziz Elamin,12 Afif Ben Salah,2 Hani Atwa6,13 1Internal Medicine Department, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain; 2Family and Community Medicine Department, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain; 3Family Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt; 4Anatomy Department, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain; 5Human Anatomy and Embryology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt; 6Medical Education Unit, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain; 7Internal Medicine Department, Faculty of Medicine, South Valley University, Qena, Egypt; 8Surgery Department, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain; 9Psychiatry Department, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain; 10Psychiatry Department, Northern Ontario School of Medicine (NOSM), Ontario, Canada; 11Obstetrics and Gynecology Department, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain; 12Pediatrics Department, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain; 13Medical Education Department, Faculty of Medicine, Suez Canal University, Ismailia, EgyptCorrespondence: Mohamed Hany Shehata, Family and Community Medicine Department, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain, Tel +97333918183, Email mohamedhks@agu.edu.bhBackground: The COVID-19 pandemic led to profound restrictions on the face-to-face learning and assessment in all educational institutions, particularly the medical schools. The College of Medicine and Medical Sciences of the Arabian Gulf University (CMMS-AGU) conducted the final exams, both theoretical and clinical components, for its MD students online. This study was conducted to evaluate the utility of online clinical exams held at CMMS-AGU.Methods: This is a cross-sectional, mixed method study that included samples from final year medical students, examiners, and heads of clinical departments. Data were collected through surveys, structured interviews, documents’ review, and calculation of online examination’s psychometrics. Descriptive statistics were used. Quantitative data were presented in the form of means and standard deviations. Responses of heads of clinical departments in the structured interview were transcribed and analyzed thematically based on three pre-established themes.Results: Quantitative and qualitative data on the utility (validity, reliability, acceptability, educational impact, and cost and feasibility) of online objective structured clinical examination (OSCE) were collected. Content validity of the online clinical examination was established through high mean scores of content representativeness, which was confirmed by the heads of clinical departments regarding the proper coverage of clinical skills. Criterion validity was established through a high correlation between clinical and theoretical exam results (r = 0.75). Reliability of the exam was established through an acceptable Cronbach’s alpha value (0.70 to 0.78) over the four days of the examinations. The examinations were perceived as highly acceptable by both students and examiners. High educational impact was inferred from students’ responses and review of documents. The examination was found to be feasible and of reasonable cost.Conclusion: Online OSCE might be a good alternative of conventional clinical assessments in times of crises and impossibility of having in-person contact between students, examiners, and patients. An important major drawback is still present in such initiatives, which is the inability to assess students’ physical examination skills.Keywords: online clinical assessment, exam utility, OSCE, COVID-19

The use of Bubble Deck in modern prefabricated construction methods has recently become widespread in industrial projects worldwide. In the middle of a typical slab, Bubble Deck places hollow plastic balls that do not improve structural performance but significantly reduce structural weight. This study analyzes the behavior of self-uniting bidirectional concrete slabs with plastic spherical voids under high temperatures and for different periods. Six simply supported bidirectional plates, five of which contained bubbles and one solid, were numerically tested using the finite element method and the commercial ABAQUS software to investigate the behavior of bidirectional plates fired at various temperatures and for various amounts of time. Each slab has the following measurements: (1500*1500*150) mm. These slabs were fired at different temperatures (600 and 800) °C and for different periods (one and two hours). The slabs were classified into four groups depending on the kind of slab (solid or bubble), the degree of burning (600 and 800) °C, and the duration of the burning (one and two hours). The loading strength of concrete was found to be up to 65% less than the maximum capacity of a slab that was bubbled and fired at high temperatures. The length of the firing time also had a significant effect on reducing the strength of the concrete. The longer the firing period, the lower the load resistance of the concrete. The ball would melt and scorch in an intense, protracted fire without noticeable effects. The ability of the steel to maintain adequate strength during a fire, when it will be burned and lose significant strength as the temperature rises, determines the slab’s ability to withstand fire. Bubble deck slabs produce between 17% and 39% stronger thermal resistance than an equivalent solid slab of the same depth, even though they are not intended to provide thermal insulation due to the encapsulation of the air bubbles within the center of the concrete slab.

Tariq O Abbas,1–3 Mohammed Abdelkareem,4 Abdelrahman Alhadi,4 Vishwanatha Kini,5 Prem Chandra,6 Abdulla Al-Ansari,4 Mansour Ali1 1Department of Pediatric Surgery, Hamad General Hospital, Doha, Qatar; 2College of Medicine, Qatar University, Doha, Qatar; 3Weill Cornell Medical College-Qatar, Doha, Qatar; 4Urology Department, Hamad General Hospital, Doha, Qatar; 5Radiology Department, Hamad General Hospital, Doha, Qatar; 6Medical Research Center, Hamad Medical Corporation, Doha, Qatar Purpose: Testicular torsion (TT) represents a clinical challenge that needs emergency surgical assessment. It is common to have negative scrotal exploration due to confounding symptoms and signs which makes it sometimes difficult to differentiate from similar surgical emergencies that do not warrant surgery. At the same time, several occasions of misdiagnoses or late interventions occur with devastating effects. We aim at delineating the significance of the different clinical, laboratory, and radiological variables in the detection of TT.Methods: We retrospectively reviewed the charts of 52 patients who were surgically explored with a preoperative working diagnosis of suspected TT in our center over the period from 2011 to 2015. All the patients were examined by pediatric surgeons in the emergency room and had undergone ultrasound imaging of the testes. The ultrasound images were retrospectively reviewed by a pediatric radiologist who was blinded to the intraoperative findings. Univariate and multivariate and logistic regression analyses were performed.Results: Of the studied group of patients, the majority (84.6%) had TT upon surgical exploration. The most frequently presented symptom was pain (80.8%), and only a minority (11.5%) presented with vomiting. Radiological findings with the highest sensitivity were heterogeneous echogenicity in favor of TT and enlarged epididymis indicating that TT is unlikely. However, the predictability of TT by any of the assessed clinical and imaging factors was statistically insignificant.Conclusion: It is important to gather all relevant data from clinical, laboratory, and imaging sources when assessing pediatric patients with suspected TT given the inaccuracy of each single one of them if used alone. Keeping this in mind, Doppler ultrasound has a significant role to aid in the accuracy of the diagnosis and hence the appropriate decision-making thereafter. However, we found no single clinical or imaging sign that is sensitive enough to prove or rule out TT. Therefore, surgical exploration should take place in a timely manner. Moreover, further research is necessary to construct scoring systems where different predictors collectively have higher reliability. Keywords: testicular torsion, Doppler ultrasound, children, spermatic cord torsion, diagnosis