Association between laboratory markers and Covid-19 disease severity and outcome: a retrospective cohort study in Saudi Arabia

Introduction

In Saudi Arabia, limited studies have evaluated factors including epidemiologic, clinical, and laboratory findings that are associated with COVID-19 disease. The aim of this paper was to identify laboratory parameters used in King Abdulaziz University Hospital which show an association with disease severity and patient outcome in the form of mortality.

Methods

Age, gender, medical history, and laboratory parameters were all retrospectively assessed concerning disease severity and disease outcome in a total of 111 COVID-19 patients at King Abdulaziz University Hospital between July 2020 and August 2020. Patients were categorized into mild disease if they did not require ward admission, moderate if they met the Ministry of Health criteria for isolation ward admition, and severe if they were admitted to the ICU.

Results

Age but not gender was associated with the disease severity X² (4, N = 110) = 27.2, p <0.001. Of all laboratory parameters on admission, only the levels of Albumin appeared to be significantly associated X² (2, N =70) = 6.6, p <0.05 with disease severity. Age but not gender was also significantly associated with disease outcome X² (2, N = 110) = 12.8, p < 0.01. Interestingly, RBC count also showed a significant relation with disease outcome X² (2, N = 71) = 6.1, p <0.05.

Discussion

This study provides more understanding of the laboratory characteristics in our part of the world to efficiently manage the disease.

Team-based learning versus traditional didactic lectures in teaching clinical biochemistry at King Abdulaziz University; learning outcomes and student satisfaction

Team-based learning (TBL), which encourages students to become active rather than passive learners, has gained world-wide popularity in medical education due to its proven positive effect on more than one aspect of the educational process. At King Abdulaziz University (KAU), clinical biochemistry is still taught in the form of didactic lectures, and while there is a need for introducing active learning, student learning response from TBL has not been explored. In this quasi-experimental non-equivalent comparison group design, we compared learning outcomes and student satisfaction in a clinical biochemistry course taught either via TBL to second year clinical nutrition students (n = 33) or via traditional lectures to same year nursing students (n = 70). The same summative post-course exam was given to both student groups to assess impact on learning. Focus group discussion and a self-administered questionnaire were used to gain insight into clinical nutrition students' level of satisfaction with TBL. In the post-course exam results of recall and reasoning questions, nursing students (Lectures) scored an average of 38% ± 2.4 in the recall questions while clinical nutrition students (TBL) scored higher with an average of 74.5% ± 4.3 (p < .0001). In reasoning questions, nursing students (Lectures) scored lower than clinical nutrition students (TBL), 23% ± 2.7 versus 40% ± 4.2, respectively (p < .001). In comparing results of pre- and post-test recall questions within each group, there was no significant difference between pre- and post-results for nursing students (Lectures) while clinical nutrition students (TBL) showed a significant increase in post-versus pre-test results of 71% versus 41% (p < .0001). In the final summative post-course exam, nursing students scored an average of 60% ± 2.4 while clinical nutrition students (TBL) scored significantly higher with an average of 78% ± 2.4 (p < .001). Qualitative studies revealed that accountability and team-work were positive aspects perceived by students regarding TBL. The study showed that 84% of surveyed students enjoyed the experience, however, when asked about challenges self-study was their main challenge. TBL proved to be a successful, learner-centered approach for clinical nutrition students at KAU in their clinical biochemistry course resulting in improved learning outcomes and higher student satisfaction when compared with traditional didactic methods of teaching.

Relationship between admission criteria and academic performance in basic science courses in health science colleges in KAU

BACKGROUND

At King Abdulaziz University, medical and health science schools depend on admission exams (aptitude and achievement) and preparatory year scores in their students' selection. However, with the growing number of applicants and the drastic changes in teaching and assessment in these colleges, continuous assessment and development of admission criteria are needed. In this study, we aimed to evaluate the correlation of admission exam scores, in addition to the preparatory year Grade Point Average (GPA), with academic performance in the basic science subjects such as Clinical Biochemistry and Clinical Pharmacology in health science colleges.

METHODS

The study was conducted on four cohort studies, two faculty of nursing cohorts; nursing students (2017-2018, n=146) nursing students (2018-2019, n=81), and two faculty of applied medical sciences cohorts, clinical nutrition students (2017-2018, n=33), and clinical nutrition students (2018-2019, n=28). The students' scores of General Aptitude Test (GAT), Scholastic Achievement Admission Test (SAAT), and preparatory year GPA were all recorded at the beginning of each semester before the beginning of courses. Clinical Biochemistry and Clinical Pharmacology exam results were recorded at the end of the semester. Correlation was done for each cohort and all cohorts pooled.

RESULTS

Results showed only a weak correlation detected between SAAT and the overall achievement in Clinical Biochemistry (r= 0.192, P= 0.042) in nursing students (2017-2018), but no correlation was seen with SAAT or preparatory year scores. There was also no significant correlation between admission exams scores and the students' academic achievement in Clinical Biochemistry or Clinical Pharmacology. On the other hand Clinical Pharmacology exam results showed a significant positive correlation with Clinical Biochemistry results (r=0.688, P=0.000).

CONCLUSION

Our results could indicate the need to revisit the admission criteria for these colleges. Furthermore, specific preparatory year tracks for health science colleges can ensure that students improve the specific skills and knowledge required for their future college years3.

Degenerative Joint Disease of the Upper Cervical Spines: A Cone Beam Computed Tomography Study

Objectives

To investigate the prevalence, imaging features, and predictors (age and gender) of upper cervical spine degenerative joint disease (DJD).

Methods

Two oral radiologists retrospectively reviewed the cone-beam computed tomography (CBCT) examinations conducted at a university-based imaging center over 1 year. They recorded the imaging findings related to the upper cervical spine (C1C2) and collected patient demographic data. Then the data of the patients with and without DJD findings in the upper cervical spine were compared.

Results

The prevalence of upper cervical DJD was 45.6%. There were no gender-based differences in upper cervical DJD. The prevalence of upper cervical DJD increased steadily with age. There was a statistically significantly difference in the prevalence of upper cervical DJD at all the age ranges.

Conclusions

DJD of the upper cervical spine is a relatively common incidental finding frequently captured in CBCT scans acquired for dental purposes.

Evaluating the long-term impact of faculty development programs on MCQ item analysis

PURPOSE

Evaluating the long-term impact of faculty development programs (FDPs) can help monitor the effectiveness of the program and identify areas for development. This study examined long-term differences in confidence, knowledge, behaviors, and policies of faculty members who attended FDPs on multiple choice question (MCQ) item analysis and faculty members who did not attend the FDPs.

METHODS

A cross-sectional study design was used, by administering a 24-item survey to a representative sample (simple random selection) of 61 faculty members at King Abdulaziz University Faculty of Medicine.

RESULTS

Among respondents, 34% did not attend FDPs; 53% attended 1-3 FDPs; and 13% attended more than 3 FDPs on MCQ item analysis. Results showed that faculty knowledge on elements of MCQ item analysis was significantly greater (p = .01) for members who attended the FDPs. Faculty who attended FDPs on MCQ item analysis were twice more likely to conduct item analysis in general (p = .020) and four times more likely to conduct item analysis for more than 70% of module examinations (p = .005).

CONCLUSION

FDPs focused on MCQ item analysis can yield systematic changes on faculty confidence, knowledge, and behaviors. Moreover, FDPs also need support from the department and need sustained strategic support to ensure continued effectiveness.