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INTRODUCTION The development of anti-platelet factor 4 (PF4) antibodies is linked to a rare thrombotic complication described now as vaccine-induced immune thrombotic thrombocytopenia (VITT). This clinical syndrome with thrombosis and thrombocytopenia was reported after exposure to the Oxford-AstraZeneca COVID-19 vaccine, ChAdOx1 nCoV-19 vaccine (AZD1222), and Ad26.COV2.S vaccine (Janssen/Johnson & Johnson). In the absence of the clinical features, the incidence of positive anti-PF4 antibodies in asymptomatic individuals post-vaccination is unclear. METHODS The aim of this study was to evaluate the development of anti-PF4 antibodies in asymptomatic individuals 14-21 days after receiving the first dose of ChAdOx1 nCoV-19 vaccine (AZD1222) and BNT162b2 vaccine. Prospectively, we collected serum from individuals before and after ChAdOx1 nCoV-19 vaccine and BNT162b2 vaccine and measured anti-PF4 antibodies using the Asserachrom HPIA IgG ELISA (Stago, Asnieres, France). RESULTS We detected positive anti-PF4 antibodies in 5 of 94 asymptomatic individuals post-vaccine with a rate of 5.3% with low titers (OD 0.3-0.7). Four of 5 individuals who tested positive after the vaccine had also positive anti-PF4 antibodies before the vaccine, which indicates that a majority of the positive results are due to preexisting anti-PF4 antibodies. We did not find a relation between the development of anti-PF4 antibodies and the immune response to the vaccine, status of prior COVID-19 infection, and baseline characteristics of participants. None of the participants developed thrombosis nor thrombocytopenia. CONCLUSION Our results provide new evidence to guide the diagnostic algorithm of suspected cases of VITT. In the absence of thrombosis and thrombocytopenia, there is a low utility of testing for anti-PF4 antibodies.

AIM: To explore levels and determinants of awareness and knowledge about glaucoma among patients. METHODS: This was a cross-sectional study that included adult patients from October to the end of December 2018. A semi-structured questionnaire was designed by the researchers to measure the levels of awareness and knowledge about 18 basic information about glaucoma. The sheet was divided into 4 domains: types of glaucoma, risk factors, clinical features, and management. A knowledge score (KS, range=0-18) was calculated, with higher scores indicating higher levels. RESULTS: A total of 383 patients responded to the questionnaire, 61.9% males, mean±SD age was 38.5±12.94 years old, and 61.6% had a university degree or higher. Of them, 6.3% and 23.2% reported personal and family history of glaucoma, respectively. The most frequently reported source of information about glaucoma was another person with glaucoma (28.2%), followed by physicians (24.8%) and TV (19.6%). Knowledge by item ranged from 3.1% to 82.5% correctness rate, while KS showed mean=5.91 and median=5; and reliability testing of the knowledge scale showed Cronbach’s alpha=0.782. Higher KS were found among respondents with higher educational level (P=0.036), diabetes history (P=0.025), and personal (P

Sami H Alzahrani,1 Rawan A Alghamdi,2 Ahmed Mabruk Almutairi,3 Ali Ahmed Alghamdi,3 Abdullah Abdulwahab Aljuhani,3 Abdulrahman Hamed ALbalawi3 1Family Medicine Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 2Ibn Sina National College for Medical Studies, Jeddah, Saudi Arabia; 3Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi ArabiaCorrespondence: Sami H AlzahraniFamily Medicine Department, Faculty of Medicine, King Abdulaziz University, PO Box 80205, Jeddah, 21589, Saudi ArabiaTel +966 9500004062Email drsamihz@gmail.comBackground: To assess knowledge and attitudes about e-smoking among undergraduate medical students, specifically focused on favorable view of therapeutic e-cigarette use for smoking cessation or harm reduction.Methods: This cross-sectional study included medical students at King Abdulaziz University, Saudi Arabia. A six-item subscale was used to explore knowledge and attitudes about the therapeutic use of e-cigarettes, measuring participants’ likelihood of favoring such use. A four-item questionnaire measured confidence and importance of being educated about smoking and e-smoking, in addition to sources of knowledge about e-cigarettes.Results: A total of 399 students participated. Smoking history included current smokers (19.8%) and ex-smokers (6.5%), while e-cigarettes were tried by 36.6% and are currently used by 11.5%. A minority (13.5%) believed that e-cigarettes are FDA-approved for smoking cessation, while approximately one-third believed e-smoking lowers cancer risks (31.1%) and could help with smoking cessation (31.1%). Further, 35.9% agreed or strongly agreed that e-cigarettes are better for patients than tobacco products, and 17.5% were likely to recommend e-smoking to their patients for smoking cessation. Reliability of the six-item scale showed Cronbach’s alpha = 0.676, which was enhanced to 0.746 after deletion of one item about addictiveness. Using the corrected five-item scale, 23.6% of the participants would favor therapeutic use of e-cigarettes.Conclusion: We observed several misconceptions about addictiveness and inadequate awareness about e-cigarettes’ harmful effects, leading to non-scientific opinions about its therapeutic use for harm reduction or in smoking cessation. Academic programs around this topic should be updated in accordance with majority expert recommendations.Keywords: e-cigarette, vaping, knowledge, therapeutic, smoking cessation, medical students, Saudi Arabia

Background Eating habits are a major concern with regard to the health status of university students. This study aimed to identify patterns of eating habits among undergraduate medical students and to investigate their relationship to sociodemographic, socioeconomic, and psychological factors. Methods This cross-sectional study included 378 undergraduate medical students aged 19-26 from the Faculty of Medicine at King Abdulaziz University, Jeddah, Saudi Arabia. Students were in their second through sixth academic year. Data were gathered with a self-administered questionnaire encompassing questions on sociodemographics, eating habits, and psychological factors. Results Eating habits score was much lower among students who were smokers, lived in rented places, lived alone, had separated parents, and did not exercise regularly. In multivariate analysis, multiple psychological factors, such as living alone and stressed, were found to be associated with eating patterns. Conclusion A majority of undergraduate medical students had unhealthy eating patterns, and socioeconomic and psychological elements were significantly affecting eating patterns.

BACKGROUND: Medical students are at higher risk of developing alexithymia due to the nature of their studies. OBJECTIVES: Determine the prevalence of alexithymia and potential risk factors among medical students in Saudi Arabia. DESIGN: A cross-sectional analytic study. SETTINGS: University medical school. PATIENTS AND METHODS: An institutional cross-sectional survey of medical students was conducted using the Toronto Alexithymia Scale (TAS-20) to assess the prevalence of alexithymia and potentially associated factors (gender, parental marital status, grade point average, status of accommodations, smoking status, year of study, childhood abuse, a history of mental illness, and physical activity). MAIN OUTCOME MEASURES: Gender, parental marital status, grade point average, status of accommodations, smoking status, year of study, childhood abuse, a history of mental illness, and physical activity. SAMPLE SIZE: 347. RESULTS: The prevalence of alexithymia among medical students was 49% (95% confidence interval [43.8–54.2]). A binary logistic regression model showed significant associations between alexithymia and academic year of study (lower risk of alexithymia in the clerkship (5th, 6th years); odds ratio [OR]: 0.43, 95% CI: 0.26–0.72), smoking (OR: 3.52, 95% CI: 1.60–3.34), grade point average (lowest; OR: 10.44, 95% CI: 4.24–25.77), history of childhood abuse (OR: 2, 95% CI: 1.20–8.77), and history of psychiatric illness (OR: 14.40, 95% CI: 4.76–21.06). CONCLUSION: Almost half of the medical students suffer from alexithymia. Increasing the awareness about alexithymia among students and directing them where to seek help would facilitate the management of these problems. LIMITATIONS: Limited only to medical students from the second year to the sixth year in a single medical college, which affects generalizability. The cross-sectional design might have also limited generalizability. CONFLICT OF INTEREST: None.

Background In higher education institutes, there are competitive and tussling environments to provide students with a high educational and service quality. Service quality is the key to meet or exceed student expectations. The quality of health systems, therefore; would be directly dependent on the quality of medical sciences education. In the current study, the modified SERVQUAL model was applied to assess the quality of the educational service provided at King Abdulaziz University (KAU) in Saudi Arabia. Methods This is a descriptive, cross-sectional study that was conducted within the Faculties of Medicine, Applied Medical Sciences, Dentistry, and Pharmacy. Through applying the modified SERVQUAL model, the gap between students' perceptions and expectations was calculated and correlated with other demographic data. The ratio of students’ perception to their expectation was calculated as a probe of student satisfaction in the current educational services to enable prioritizing items for improvement. Results The response rate was 89% (n = 266). Out of the 266 participants, 87% were females and 13% were males. Comparisons between the gap values of male and female students showed a significant difference in the assurance and responsiveness dimensions of the educational service quality at KAU. The results showed that all items have negative gap values (except item 24). The findings showed a significant difference of students’ opinion in SERVQUAL dimensions among different Faculties except in empathy. Conclusion The findings of this study showed that all dimensions were not up to the expectations of students. Reliability dimension and its items should be given the highest priority for improvement based on gap, ratio, and service improved matrix. The findings of this study will be very useful for the higher management to design the University Strategic Plan with well-defined direction and priorities for the improvement processes based on SERVQUAL outcomes.

Objectives:To assess the levels and the associated demographic factors with diabetic self- management (DSM) among diabetic patients in Saudi Arabia. The impact of implementing DSM practices on glycemic control was additionally investigated.Results:The responses of 349 patients were analyzed (51.0% males and 37.2% obese). The median (IQR) raw DSMS score was 187 (165-205). Higher DSMS scores were reported for young adults (aged 20-29 years), insulin users, employed patients, as well as those with normal body mass index values and normal HbA1c results compared to their counterparts. Low HbA1c values were linearly associated with high scores of the healthy eating (β = -0.014, p=0.018) and physical activity subscales (β = 90-0.009, p=0.042).Keywords : Self-management; diabetes; glycemic control; Saudi Arabia.

Objectives: To investigate adipocytokines’ (vaspin, omentin-1, and adiponectin) correlation with metabolic phenotypes in type 2 diabetes mellitus (T2DM) patients. Methods: This case-control research was done at the Diabetic Clinic in Jeddah, Kingdom of Saudi Arabia (KSA), from November 2018 to March 2019. Seventy-five T2DM patients and 75 gender, age, and BMI-matched healthy subjects were recruited for this research. Results: In DM patients, the concentrations of serum vaspin and omentin-1 were substantially lower (p25, and no gender-wise variance was observed in adipocytokines levels. Binary logistic regression analysis showed a significantly negative predictive relationship of vaspin and omentin-1 with DM. Conclusion: The DM group displayed substantially lower serum vaspin and omentin-1 levels. However, there was no consistent relationship observed between these adipocytokines and metabolic phenotypes. doi: https://doi.org/10.12669/pjms.37.7.4330 How to cite this:Baig M, Gazzaz ZJ, Bakarman MA, Alzahrani SH. Correlation of Serum Vaspin, Omentin-1, and adiponectin with metabolic phenotypes in Type-2 diabetes mellitus patients. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4330 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Objectives: To find out medical students’ perceptions and attitudes toward medical leadership and management (MLM). Methods: A total of 336 medical students from the 2nd to 6th academic years from King Abdulaziz University (KAU), Jeddah, Kingdom of Saudi Arabia (KSA), were included in this cross-sectional study. This study was conducted in January-February 2020. The students were asked about their perceptions, attitudes, and interests in the leadership of medical care and clinicians. A four-part questionnaire was used for collecting data. SPSS-21 was used for analysis. Results: The participants included 172 (51.2%) males and 164 (48.8%) females. In total, 105 (31.3%) participants agreed that they had been very well educated about their perception, behavior, and interest in the field of medical leadership and clinic management, and 175 (52.1%) students agreed that clinicians should influence management decisions in a healthcare setting. Overall, 167 (49.7%) students agreed that management/leadership skills are important for clinicians. In total, 145 students (43.2%) desired to have more leadership training in medical school, and 129 (38.4%) students agreed to seek additional leadership/management training in their postgraduate research studies. When asked about their self-perception of good leadership skills, the students indicated that good leadership skills included integrity (47.9%), conflict resolution (46.7%), organization (44.4%), confidence (41.9%), communication (40.5%), self-reflection (40.2%), time management (33.6%), the ability to motivate others (36.9%), and the ability to keep calm under stress (33.3%). Conclusion: Many students were well aware of the MLM concepts. However, students agreed that management/leadership skills are important for clinicians, and there should be more leadership training in medical schools. doi: https://doi.org/10.12669/pjms.37.1.2406 How to cite this:Alzahrani SH, Baig M, Omer AR, Algethami MR. Medical Students’ Perceptions and Attitudes Toward Medical Leadership and Management. Pak J Med Sci. 2021;37(1):223-228. doi: https://doi.org/10.12669/pjms.37.1.2406 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Objective To assess the level and determinants of practice in diabetes self-management at primary health care centers (PHCCs) and to analyze the association of self-management with the level of glycemic control. Method A cross-sectional study was conducted among patients with type 1 and type 2 diabetes, aged ≥ 17 years, and being followed at PHCCs in Jeddah, Saudi Arabia, from December 1, 2019, to December 30, 2019. A multistage cluster sampling technique was used to select 350 participants from five PHCCs. The level of practice in self-management was assessed using the Arabic version of the Summary of Diabetes Self-care Activities (SDSCA) questionnaire. The tool was administered as a face-to-face interview, followed by the collection of sociodemographic and relevant clinical data. In addition, blood was collected to measure fasting blood glucose (FBG) and HbA1c levels. The association of the overall SDSCA score with diabetes control was analyzed using linear regression and the receiver operator characteristics (ROC) curve. Multivariate binary logistic regression was carried out to analyze independent factors of inadequate practice. Result The overall mean (SD) SDSCA score was 3.13 (1.13)/7. Of the five dimensions of self-care, medication adherence yielded the highest score (mean=5.39 days per week), followed by diet (2.83) and blood glucose monitoring (2.78), while footcare had the lowest level of practice (2.26). The SDSCA score showed a negative correlation with the level of HbA1c, with a correlation coefficient r-squared =0.530 and regression coefficient B=-0.648 (p 50 years (OR=2.00 [95%CI=1.02, 3.89]), rental accommodation (OR=0.42 [95%CI=0.23, 0.76]), independent job (OR=3.98 [95%CI=1.66, 9.57]), and longer duration of diabetes (≥8 years) (OR=4.25 [95%CI=1.82, 9.92]). Conclusion There are low levels of diabetes self-management among patients being followed at Jeddah PHCCs. This is associated with suboptimal glycemic control among the majority of the patients, indicating the importance of self-management to improve diabetes control. Patient health literacy and education for self-management should be considered the standard of care for diabetic patients in all PHCCs, with specific attention to subcategories of patients with the lowest levels of practice in self-management such as those with a longer duration of diabetes and the elderly.

Vaccine uptake could influence vaccination efforts to control the widespread COVID-19 pandemic, however, little is known about vaccine acceptance in Saudi Arabia. The present study aimed to assess the Saudi public’s intent to get vaccinated against COVID-19 and explore the associated demographic determinants of their intentions as well as the reasons for vaccine hesitancy. A cross-sectional, web-based survey was distributed to public individuals in Saudi Arabia between 25 December 2020 and 15 February 2021. Participants were asked if they were willing to get vaccinated, and the responses, along with demographic data were entered into a multinomial logistic regression model to assess the relative risk ratio (RRR) for responding “no” or “unsure” versus “yes”. Among 3048 participants (60.1% female, 89.5% Saudi), 52.9% intend to get vaccinated, 26.8% were unsure, and 20.3% refused vaccination. Vaccine hesitancy was significantly higher among females (RRR = 2.70, p &lt, 0.0001) and those who had not been recently vaccinated for influenza (RRR = 2.63, p &lt, 0.0001). The likelihood was lower among Saudis (RRR = 0.49, p &lt, 0.0001), those with less than a secondary education (RRR = 0.16, p &lt, 0.0001), perceived risks of COVID-19, and residents of the southern region (RRR = 0.46, p &lt, 0.0001). The most often cited reasons for hesitancy were short clinical testing periods and concerns about adverse events or effectiveness. Vaccine hesitancy is mediated by many demographic factors and personal beliefs. To address vaccine-related concerns and amend deeply rooted health beliefs, communication should provide transparent information.

BACKGROUND: Poisoning is a significant global public health challenge in terms of morbidity and mortality. We conducted this study because of the lack of large population-based studies on chemical poisoning in Saudi Arabia. OBJECTIVE: Describe epidemiological trends, associated factors, and outcomes of chemical poisoning cases reported to the Jeddah Health Affairs Directorate, Saudi Arabia. DESIGN: Descriptive, retrospective medical record review. SETTING: Population database for the Jeddah Governorate. METHODS: For chemical poisoning cases reported from January 2011 to December 2015, data was collection using a standardized, validated data collection sheet. Data was collected on personal characteristics, type of chemical poisoning and outcome. MAIN OUTCOME MEASURE(S): Descriptive epidemiological data and statistical comparisons. RESULTS: For 994 chemical poisoning cases, an increasing trend was observed from 2011 to 2013 followed by some reduction during 2014 and 2015. The highest percentage of cases occurred during July followed by March for the cumulative total cases by month for all years. More than half of the cases involved males (55%), and children aged less than 5 years (56.6%). About three-fourths of the cases occurred accidentally and through ingestion. The most common poisonous agents were detergents (36.0%). Poisoning with addictive drugs occurred in 13 cases (1.3%). Only 1.1% of cases received a poisoning specific antidote, and the same percentage died because of poisoning. Gender, age, nationality, the route and the circumstances of the exposure were significantly associated with the type of poisoning (P

Sami Hamdan Alzahrani,1 Mukhtiar Baig,2 Mooataz Mohammed Aashi,3 Faisal Khaled Al-shaibi,4 Dalya Abdulrahman Alqarni,4 Wael Hassan Bakhamees41Family Medicine Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 2Department of Clinical Biochemistry, Faculty of Medicine, Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia; 3Pediatric Department, King Abdulaziz University Hospital, Jeddah, Saudi Arabia; 4Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi ArabiaCorrespondence: Sami Hamdan AlzahraniFamily Medicine Department, Faculty of Medicine, King Abdulaziz University, P.O. Box 4828, Jeddah 22431, Saudi ArabiaTel +966 950 000 4062Email drsamihz@gmail.comBackground: To investigate the association between glycated hemoglobin (HbA1c) and the lipid profile in patients with type 2 diabetes mellitus (T2DM) at a tertiary care hospital in Jeddah, Saudi Arabia (SA).Methods: The present retrospective cross-sectional study was accomplished at the Faculty of Medicine, King Abdulaziz University (KAU), Jeddah, SA, between April and July 2018. There were 206 T2DM patients selected for the study (141 females and 65 males), and the data were collected through a review of the electronic profiles of patients by using the medical electronic file system used at the KAU Hospital. Biochemical data such as fasting plasma glucose (FPG), HbA1c and lipid profile, along with the patient’s age, BMI and gender, were also taken from the electronic file system. The inclusion criteria allowed for only patients who were regularly seeing their physician and whose electronic file was up to date.Results: The participants’ data were analyzed gender-wise. The females had significantly higher values for BMI (p=0.002), HbA1c (p=0.009), triglycerides (TGs) (p7%). In both groups, no significant differences were found in any of the parameters other than TGs (p=0.020) and HbA1c (p

Background This study investigated the prevalence and association of liver transaminases in type 2 diabetes mellitus (T2DM) patients at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia. Methods This retrospective, cross-sectional study was carried out on 211 T2DM patients at KAUH in 2017, and the Research Ethics Committee of KAUH approved this study. The data were analyzed on SPSS 21 (IBM Corp., Armonk, NY, US). The association of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) with several risk factors was computed by the chi-square test. The odds ratio with a 95% confidence interval (CI) was also calculated. Results The mean age of study participants was 60 ± 13.43 years; 143 (67.8%) were female while 68 (32.2%) were male. Serum AST levels were elevated in 6.16% (10.3% in males, 4.2% in females). Elevated ALT levels were found in 7.58% (11.8% in males, 5.6% in females) (Table 2). The probability of rising AST levels increased with age (OR = 2.59 for patients aged 46-65) and with male gender (OR = 2.65, CI: 0.84-8.12). Additionally, the probability of rising ALT levels increased with male gender (OR = 2.25, CI: 0.80-6.27), low-density lipoproteins (LDL-C) (OR = 2.11, CI: 0.73-6.04), and triglycerides (TG) (OR = 2.08, CI: 0.739-5.87). No statistically noteworthy association was observed between elevated levels of AST and ALT with gender, age, body mass index (BMI), glycated hemoglobin (HbA1c), TG, total cholesterol (TC), LDL-C, and high-density lipoprotein cholesterol (HDL-C) levels, smoking, or hypertension. Conclusion Higher ALT and AST levels were found in T2DM patients but with no statistically significant link between elevated levels and gender, age, BMI, HbA1c, TG, TC, HDL-C, LDL-C, smoking, or hypertension.

This study intends to explore the predictors of misconceptions, knowledge, attitudes, and practices concerning the COVID-19 pandemic among a sample of the Saudi population and we also assessed their approaches toward its overall impact. This online cross-sectional survey was conducted at the Faculty of Medicine, Rabigh, King Abdulaziz University (KAU) in Jeddah, Saudi Arabia (SA). Participants were approached via social media (SM), and 2006 participants (953 [47.5%] females and 1053 [52.5%] males) were included in this study. SM was the leading source of information for 43.9% of the study participants. Most of the participants had various misconceptions such as “females are more vulnerable to develop this infection, rinsing the nose with saline and sipping water every 15 minutes protects against Coronavirus, flu and pneumonia vaccines protect against this virus.” About one-third of participants (31.7%) had self-reported disturbed social, mental, and psychological wellbeing due to the pandemic. Many participants became more religious during this pandemic. Two-thirds of the study participants (68.1%) had good knowledge scores. Attitudes were highly positive in 93.1%, and practice scores were adequate in 97.7% of the participants. Participants’ educational status was a predictor of high knowledge scores. Male gender and divorced status were predictors of low practice scores, and aged 51–61 years, private-sector jobs, and student status were predictors of high practice scores. Being Saudi was a predictor of a positive attitude, while the male gender and divorced status were predictors of a negative attitude. Higher education was a predictor of good concepts, while the older age and businessmen were predictors of misconceptions. Overall, our study participants had good knowledge, positive attitudes, and good practices, but several myths were also prevalent. Being a PhD and a Saudi national predicted high knowledge scores and positive attitudes, respectively. A higher education level was a predictor of good concepts, and students, private-sector jobs, and aged 51–61 years were predictors of high practice scores. Study participants had good understanding of the effects of this pandemic.

BACKGROUND: Malnutrition is highly prevalent among the elderly and is associated with poor clinical prognosis, decreased functional status, and increased morbidity and mortality. OBJECTIVE: To estimate the prevalence of geriatric malnutrition among outpatients of a geriatric clinic and to determine factors associated with malnutrition. DESIGN: Cross-sectional study. SETTING: Geriatric outpatient clinic of the King Abdul Aziz University Hospital, Jeddah. PATIENTS AND METHODS: All patients older than 60 years of age who attended the clinic during January 2016 were eligible for inclusion. Nutritional status was assessed using anthropometric data and by hemoglobin and albumin levels and lymphocyte count. The MNA was used to define malnutrition. MAIN OUTCOME MEASURES: Anthropometric measures, biochemical tests, and the scores on the short version of the Mini Nutritional Assessment (MNA). RESULTS: According to the MNA results, 8 (5.3%) of 152 elderly patients suffered overt malnutrition and 50 (32.9%) were at risk of malnutrition (71 males and 41 females; aged 72.4 [8.6] years). The prevalence of malnutrition was significantly higher among females (44.6%; 95% CI, 1.01–4.08; P=.044) than in males (28.3%). Malnourished patients were older than patients with normal nutritional status (mean 72.4 [8.6] years), and more common in patients who lived alone (62.5%). The malnourished patients had significantly smaller calf circumferences (63.4; 95% CI, 1.51–3.20; P=.001), and lower albumin and hemoglobin levels (P=.001). A significantly higher percentage of the malnourished patients compared with normal patients had experienced weight loss (37.9%; P

Objectives. This study assessed the knowledge and attitudes regarding complementary and alternative medicine (CAM) in medical students in Saudi Arabia. Furthermore, it evaluated their views on the incorporation of CAM in their medical syllabus.Methods. The study was conducted by selecting a cross-sectional sample of senior medical students in the Faculty of Medicine. A validated and reliable self-administered questionnaire was used to explore the knowledge, attitude, and benefits of CAM. It was distributed to a sample of 273 students.Results. The study included 242 students, making the response rate 88.6%. Only two-thirds of students (62.4%) were aware of acupuncture principles and only 17.4% recognized that chiropractic is associated with pain management. The knowledge of common herbs such as St. John’s Wort,Echinacea, andGinkgo bilobawas limited among the students. Older students had a positive CAM attitude compared to younger students (p=0.027).Conclusion. Students attitudes toward CAM learning were encouraging regardless of their limited knowledge on the subject. A high percentage of students agreed that CAM in combination with conventional therapy is beneficial in treating unusual cases, but the choice of CAM should be based on evidence. Furthermore, medical students are still reluctant to have CAM practitioners in their referral network.

Medical students are at higher risk of developing alexithymia due to the nature of their studies.Determine the prevalence of alexithymia and potential risk factors among medical students in Saudi Arabia.A cross-sectional analytic study.University medical school.An institutional cross-sectional survey of medical students was conducted using the Toronto Alexithymia Scale (TAS-20) to assess the prevalence of alexithymia and potentially associated factors (gender, parental marital status, grade point average, status of accommodations, smoking status, year of study, childhood abuse, a history of mental illness, and physical activity).Gender, parental marital status, grade point average, status of accommodations, smoking status, year of study, childhood abuse, a history of mental illness, and physical activity.347.The prevalence of alexithymia among medical students was 49% (95% confidence interval [43.8-54.2]). A binary logistic regression model showed significant associations between alexithymia and academic year of study (lower risk of alexithymia in the clerkship (5th, 6th years); odds ratio [OR]: 0.43, 95% CI: 0.26-0.72), smoking (OR: 3.52, 95% CI: 1.60-3.34), grade point average (lowest; OR: 10.44, 95% CI: 4.24-25.77), history of childhood abuse (OR: 2, 95% CI: 1.20-8.77), and history of psychiatric illness (OR: 14.40, 95% CI: 4.76-21.06).Almost half of the medical students suffer from alexithymia. Increasing the awareness about alexithymia among students and directing them where to seek help would facilitate the management of these problems.Limited only to medical students from the second year to the sixth year in a single medical college, which affects generalizability. The cross-sectional design might have also limited generalizability.None.

Objectives: Health promotion is the main strategy for encouraging people to adopt a healthy lifestyle and for preventing non-communicable diseases. Medical students, in particular, are expected to have an important role in health promotion in their near future as physicians. The aim of this study was to determine and evaluate all six components of the Health-Promoting Lifestyle Profile and its sociodemographic determinants among medical students. Methods: A cross-sectional descriptive study was conducted in January 2018 in Jeddah, Saudi Arabia. The questionnaire used in this study consisted of two parts: the first part included sociodemographic questions and body mass index measurement and the second part consisted of questions from the Health-Promoting Lifestyle Profile II. Results: The study enrolled 243 medical students, of which 55.1% were male, 39.5% were in their fifth year, and more than half had a monthly family income above 20,000 Saudi Riyal. The mean body mass index of the respondents was 25.1 ± 5.2 (range = 13.7–43.8). The total mean score of the Health-Promoting Lifestyle Profile II was 123.8 ± 19.8 (range = 72–191). Study findings showed that health-promoting profiles differed by gender, particularly with respect to physical activity and interpersonal relationships. Factors were found to be associated with the Health-Promoting Lifestyle Profile II subscales, including income and year of study. Conclusions: University students, and in particular health science students, represent an appropriate area for health promotion interventions to be established.

Objective: To investigate smartphone addiction among medical students and to determine factors associated with smartphone addiction among sixth-year medical students at King Abdulaziz University, Jeddah. Methods: This cross-sectional study was conducted on 203 sixth-year medical students at the Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia, during July 2017. Data analysis was done using SPSS-20. Results: The number of completed questionnaires received was181 out of 203, making a response rate of 89%. There were 87 male respondents (48.1%) and 94 female respondents (51.9%). The overall prevalence of smartphone addiction was 66 (36.5%). There is a statistically significant relationship between daily hours of smartphone usage and smartphone addiction (p

Objective: To assess the knowledge and attitudes of resident physicians toward biostatistics and research methodology concepts. Methods : We conducted a cross-sectional study between November 2014 and October 2014 at King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia. A self-administered questionnaire was distributed to all participants. The response rate was 90%. Results: One hundred sixty-two resident completed the questionnaire. Most residents were well-informed in basic concepts, such as, “ P ” values, study power, and case control studies; more than half had confidence in interpreting the results of scientific papers. Conversely, more than 67% of the residents were not knowledgeable on more sophisticated terms in biostatistics. Residents with previous training in evidence-based medicine (EBM) ( p =0.05) and non-specialist residents ( p =0.003) were more likely to have better knowledge scores. Females ( p =0.003), and those with previous training in biostatistics and epidemiology had positive attitude toward biostatistics ( p less than 0.001 in both cases). Residents who read medical journals scored lower than those who never read journals ( p =0.001). Conclusion: Prior courses in EBM, as well as male gender were associated with knowledge scores. Reinforcing training after graduation from medical school with special focus on integrating biostatistics with epidemiology and research methods is needed. Saudi Med J 2015; Vol. 36 (10): 1236-1240 doi: 10.15537/smj.2015.10.11842

Objective Drug poisoning is a globally common cause of emergency-room admissions. This study explores drug-poisoning prevalence patterns, associated risk factors (gender, age and exposure circumstances), and outcomes in western Saudi Arabia. Methods Retrospective analysis of Clinical drug poisoning cases (2011-2016). The data were retrieved from the Saudi Ministry of Health's record and Patients' medical charts were analyzed. Results The Ministry of Health received 1,474 reports of drug poisoning during 2011-2016. More than half involved females (n=885, 60%) or young children (0-4 years old) (n=764, 51.8%) and occurred accidentally (n=786, 53.3%); almost all had an oral route of poisoning (n=1,466, 99.5%). The cases most frequently involved analgesic and non-steroidal anti-inflammatory drugs (n=373, 25.2%); antiepileptic, antipsychotic, psychoactive, and anxiolytic drugs (n=229, 16.3%); antihistamine, asthma, flu, and cough drugs (n=157, 12.0%); and antibiotic, anti-fungal; and antiprotozoal drugs (n=74, 5.0%). Antidotes were administered in only 2.2% of cases, and no deaths were reported. Conclusion The drug poisoning cases involved females and young children (younger than 5 years old) and the most cases were accidental, and the most commonly used drugs were analgesics (Panadol), followed by antipsychotics, antihistamines, and antiepileptics (Tegretol).

Background:Diabetic retinopathy (DR) is the most common microvascular complication of diabetes mellitus (DM) and the foremost cause of blindness. This study aimed to assess the level of awareness of DR and its related risk factors among patients with DM in Jeddah, Saudi Arabia.Methods:A cross-sectional study was conducted among patients with DM attending primary health care centers at the Ministry of Health in Jeddah. A structured, pretested, self-administered questionnaire was used to collect information on the sociodemographic and DM- and DR-related characteristics of the patients.Results:A total of 377 patients were enrolled. About 82.6% of the patients were aware that DM can affect their eyes, and they listed physicians, ophthalmologists, television, and family members as common sources of information on the topic. About 36% of the patients reported that their doctors had not advised them about it. More than half responded that they did not feel their vision to be affected by DM. More than 58% had never been diagnosed with DR. About 35% did not go to their eye checkups, even though around 59% thought that DR could lead to blindness. Of the 64% of patients whose DM was well controlled, 11% and 25% listed surgery and laser treatment, respectively, as available treatment options for DR. The following factors were found to be significant in relation to the subjects’ awareness that DM can affect their eyes: the patients’ perception of their doctors’ advice about DR; the experience of having their vision affected by DM; the knowledge that DR may lead to blindness; the practice of going to eye checkups.Conclusions:Despite having good awareness about DM and its effects on eyes, the patients exhibited a relative lack of awareness about DR. Considering the association of DR with DM, its increasing magnitude is a potential burden on the community and health systems.

Background Mental disorders are considered important public health problems not only to people with mental illness but also their caregivers. As is the case in many countries, the deinstitutionalization of mental health services in Saudi Arabia, has meant that informal caregivers are shouldering responsibilities for which they are not usually prepared; therefore, the current study was aimed at assessment of the burden on caregivers of people with mental illness. Methods Through a cross-sectional design, a sample of the caregivers of people with mental illness (n = 377) was selected randomly from a psychiatric hospital in Jeddah. An Arabic version of the Involvement Evaluation Questionnaire (IEQ) was used for collection of data. The data were analyzed on the subscale scores and the 27 items in two ways. First, we used the summed scores for the subscales based on the Likert scale (0–4) for univariate and multivariate statistical analyses, as recommended. We also used parametric statistics (t-tests, one-way ANOVA) because the IEQ subscale scores were fairly normally distributed. Results Males constituted more than one-half of the participating caregivers (55%), with a mean age of 36.6, SD = 11.4 years. As reported by the caregivers, most of the patients were males (62.7%) with a mean age of 33.8, SD = 13.7 years and a range of 17–90 years old. The total mean IEQ burden score of the caregivers was 38.4, SD = 17.5. “Tension” was significantly prominent among younger caregivers aged ≤30 years. “Worrying” was significantly higher among caregivers living with their spouse and children and those living in families with relatively fewer members (