Patient's Perceptions and Attitudes Towards Medical Student's Involvement in Their Healthcare at a Teaching Hospital in Jordan: A Cross Sectional Study

BACKGROUND

Medical students' involvement in patients' care varies according to patient's willingness, as some might consider it a privacy invasion. Thus, exploring patients' perceptions and attitudes towards this interaction should be thoroughly investigated, to better understand it and to provide evidence-based data for improving the training of future doctors.

METHODS

A cross-sectional study was conducted at Jordan University Hospital. A questionnaire was answered by 420 patients from the out-patients' clinics.

RESULTS

Of the patients interviewed, 94% were aware that they were in a teaching hospital, 92% approved the presence of medical students during their consultation and 80% accepted to be observed and examined by medical students in the presence of a senior doctor. However, this decreased to 30.5% if there was no senior doctor. Almost 83% of the patients believed that their consent should be obtained first. However, only 58% of them indicated that the student asked for consent prior to interacting with them. Patients who were more likely to approve the existence of medical students during consultation and allow students to perform procedures on them, respectively, were those who were asked for consent by students (P = 0.001 and P = 0.021), considered seeing medical students' enjoyable (P < 0.001 and P < 0.001), thought that their privacy was not violated (P < 0.001 and P < 0.001), and were provided with useful information about their health problems (P < 0.001 and P < 0.001).

CONCLUSION

Patients showed an overall positive stance towards the involvement of medical students in their healthcare. The majority were delighted to see medical students while some expressed concerns over their privacy due to the large number of students and because several students do not ask for their consent. It is essential to apply medical ethics practices together with patient-centered approach.

Public health workers' knowledge, attitude and practice regarding COVID-19: the impact of Field Epidemiology Training Program in the Eastern Mediterranean Region

BACKGROUND

This study aimed to compare knowledge, attitude and practice (KAP) regarding COVID-19 between public health workers (PHWs) attended field epidemiology training program (FETP-trained) and those who did not attend FETP (non-FETP trained).

METHODS

Multi-country cross-sectional survey was conducted among PHWs who participated in COVID-19 pandemic in 10 countries at EMR. Online questionnaire that included demographic information, KAP regarding COVID-19 pandemic was distributed among HCWs. Scoring system was used to quantify the answers, bivariate and Multivariate analysis performed to compare FETP-trained with non-FETP trained PHWs.

RESULTS

Overall, 1337 PHWs participated, with 835 (62.4%) < 40 years of age, and 851 (63.6%) males. Of them, 423 (31.6%) had FETP, including that 189 (44.7%) had advanced level, 155 (36.6%) intermediate and 79 (18.7%) basic level training. Compared with non-FETP trained, FETP trained were older, having higher KAP scores. FETP participation was low in infection control, and PH laboratories. KAP mean scores for intermediate level attendees are comparable to advanced level.

CONCLUSIONS

FETP-trained are having better KAP than non-FETP PHWs. Expanding the intermediate level, maintain the Rapid Response training and introduce the laboratory component are recommended to maximize the benefit from FETP. Infection control, antimicrobial resistance and coordination are areas where training should include.

Mental health impacts of COVID-19 on healthcare workers in the Eastern Mediterranean Region: a multi-country study

Background

Healthcare workers (HCWs) fighting against the COVID-19 pandemic are under incredible pressure, which puts them at risk of developing mental health problems. This study aimed to determine the prevalence of depression, anxiety, and stress among HCWs responding to COVID-19 and its associated factors.

Methods

A multi-country cross-sectional study was conducted during July–August 2020 among HCWs responding to COVID-19 in nine Eastern Mediterranean Region (EMR) countries. Data were collected using an online questionnaire administered using KoBo Toolbox. Mental problems were assessed using the Depression, Anxiety, and Stress Scale (DASS-21).

Results

A total of 1448 HCWs from nine EMR countries participated in this study. About 51.2% were male and 52.7% aged ≤ 30 years. Of all HCWs, 57.5% had depression, 42.0% had stress, and 59.1% had anxiety. Considering the severity, 19.2%, 16.1%, 26.6% of patients had severe to extremely severe depression, stress, and anxiety, respectively. Depression, stress, anxiety, and distress scores were significantly associated with participants’ residency, having children, preexisting psychiatric illness, and being isolated for COVID-19. Furthermore, females, those working in a teaching hospital, and specialists had significantly higher depression and stress scores. Married status, current smoking, diabetes mellitus, having a friend who died with COVID-19, and high COVID-19 worry scores were significantly associated with higher distress scores.

Conclusions

Mental problems were prevalent among HCWs responding to COVID-19 in EMR. Therefore, special interventions to promote mental well-being among HCWs responding to COVID-19 need to be immediately implemented.

Risk Factors of COVID-19 Critical Outcomes in the Eastern Mediterranean Region: A Multicountry Retrospective Study

BACKGROUND

The establishment of empirical evidence in the Eastern Mediterranean Region (EMR) necessitates the implementation of wide-scale studies to describe the demographic, clinical features, and severity profile of COVID-19 patients.

OBJECTIVE

This study aimed to assess the patterns of COVID-19 severity and mortality in seven countries and to determine the risk factors of COVID-19 severity and mortality.

METHODS

This multi-country study was based on a retrospective review of medical records of hospitalized patients confirmed to have COVID-19. This study included data from Iraq, Pakistan, Sudan, Somalia, Morocco, Egypt, and Yemen. All demographic and clinical data were extracted from hospital records (paper files) by trained data collectors.

RESULTS

A total of 4141 patients were included in this study from seven countries. Comorbidities were reported by nearly half of the patients, with hypertension (HT) (24.7%) and diabetes (22.7%) being the most common. Older age, diabetes mellitus, hypertension, and heart diseases were significantly associated with COVID-19 severity and mortality. Ever smoking and renal diseases were significantly associated with severity but not mortality, while male gender, respiratory diseases, and malignancy were significantly associated with mortality but not severity.

CONCLUSIONS

The study confirmed the role of comorbidities and demographic features on the severity and mortality of COVID-19. Understanding the contributing factors ensures attentive care and informs clinical management of patients with poorer prognoses in the early stages of diseases.

Urinary TNF-like weak inducer of apoptosis (TWEAK) as a biomarker of lupus nephritis

BACKGROUND

Renal involvement in systemic lupus erythematosus (SLE), known as lupus nephritis (LN), is a common and severe complication and a major predictor of poor outcome. Long-term survival in SLE can be improved with early diagnosis and prompt treatment of LN. A number of biochemical markers are currently used to clinically assess disease activity in patients; however, they lack sensitivity and specificity for differentiating renal activity and damage in LN. A reliable clinical biomarker that can forecast LN flare and which could be sequentially followed would help to optimize initiation and escalation of therapy at the time of active or relapsing disease.

OBJECTIVE

This study was carried out to investigate the value of urinary tumor necrosis factor (TNF)-like weak inducer of apoptosis (uTWEAK) as a biomarker for active lupus nephritis.

PATIENTS AND METHODS

A total of 44 patients with SLE fulfilling the 1997 revised criteria for the classification of SLE as well as 11 age and sex-matched healthy controls were included in this study and subjected to full medical history taking, clinical examination, routine laboratory investigations, measurement of uTWEAK level as well as renal biopsy for patients with active LN.

RESULTS

The uTWEAK levels were significantly higher in SLE patients with active LN compared to those without or with inactive renal disease and normal healthy subjects.

Molecular and serological survey of some haemoprotozoan, rickettsial and viral diseases of small ruminants from Al-Madinah Al Munawarah, KSA

The prevalence of some viral and haemoprotozoan infections in goats and sheep was investigated in the present study. The infections of Anaplasma spp. and Theileria spp. were encountered by PCR and cELISA for the detection of Anaplasma spp. Anaplasma spp. was more prevalent than Theileria spp. with a significant difference (Pvalue<0.05) in both goats and sheep, but, the infection in sheep was more prevalent than goats. Also four viral infections were detected: Rift Valley Fever Virus (RVFV), Bluetongue Virus (BTV), Madina Visna Virus (MVV) and Schmallenberg, (SBV) with an overall prevalence of 56.6%, 40.4%, 36.0%, and 6.8% respectively. The factors related to the infections were also investigated. Detection of the antibodies against examined viruses and Anaplasma spp. indicated the widespread of these infections. So far to our knowledge, this is the first study that estimates the prevalence and distribution of MVV and SBV antibodies in Saudi Arabia. Both RVFV and BTV are widespread in KSA, causing Viremia in 7.2% and 25% respectively of total samples. These findings suggested that parasitic and viral infections are considered as important health risks for sheep and goats. For this reason, the current study introduces invaluable information for different governmental agencies for dealing with infection control meausers.

Tegumental alterations of Fasciola gigantica due to in vitro treatment with Ro-354

Triclabendazole is the drug of choice against Fasciola infections in humans and animals. However, parasite resistance against triclabendazole is spreading in veterinary field, and there are no drugs of comparable activity currently available for the treatment and control of fascioliasis. The efficacy of a new rhodanine derivative Ro-354 against adult Fasciola gigantica in vitro was investigated. One hour post incubation, scanning and transmission electron microscopic examination revealed an evident disruption of the tegument of F. gigantica as blebbing, swelling and furrowing. Moreover, an increase in severity of tegumental damage as sloughing and absence of spines was observed. In conclusion, Ro-354 shows potent activity against F. gigantica in vitro, and, the authors recommend carrying out more studies to detect its efficacy in vivo.

Ferula harmonis 'zallouh' and enhancing erectile function in rats: efficacy and toxicity study

Ferula harmonis, which is locally called 'zallouh' in the Middle East, is used as an aphrodisiac as it is reputed to enhance male sexual behavior, however, there is no scientific verification. In this study, the oil extracted from the seeds of Ferula harmonis was tested for its efficacy in enhancing erectile function and toxicity in male rats. The sexual activities assessed by penile erection index were dose dependent. The ED(50) (12.03 mg/kg) was 880 times less than the LD(50) (10.6 g/kg). However, when doses ranging from 0.05, 0.5 to 2 g/kg were given daily for 28 days, acute and subacute toxicity were observed. There was a decrease in total body weight, hepatomegaly, atrophic testis, significant decrease in hemoglobin and red blood cell count. In addition, there was a significant decrease in cholesterol level. All the above indicate that the crude oil from the plant Ferula harmonis can enhance erectile function, however, it becomes toxic if it is used for a long period of time. Further studies are underway to isolate and identify the active ingredients and their exact mechanisms of action.

Comparative SDS-page protein patterns of four ascaridid nematodes

In order to investigate the degree of homogeneity and heterogeneity of the ascaridid nematodes. Toxascaris leonina, Parascaris equorum, Toxocara canis and T. vitulorum, protein extracts from adult worms of the four nematodes were resolved into a number of bands. Comparative analysis of dominant bands showed that 13 bands were common among the four species, but certain unique bands were also found in each species including 4 in T. vitulorum, one in T. leonina, two in T. canis, while P. equorum shares both T. canis and T. leonina in most of their bands. Among the four ascaridid studied, T. vitulorum appears to be the most divergent species.