Radiology in the Undergraduate Medical Curriculum: The Student Perspective

OBJECTIVE

Despite the importance of radiology in the diagnosis and management of patients, studies suggest that medical graduates exhibit a minimal level of radiology knowledge. This study aimed to assess the satisfaction of Kuwait's medical students with the radiology teaching and their confidence in their knowledge regarding basic radiological principles, as well as their views and suggestions for adequate teaching time and pattern of radiology teaching at the undergraduate level.

SUBJECTS AND METHODS

This cross-sectional study was conducted among medical students in Kuwait University. The study employed a questionnaire, which aimed to assess the students' perception of the current radiological teaching approach. Ethical approval was obtained, and descriptive analysis was conducted using SPSS.

RESULTS

Ninety-one percent of the 451 participants believed that the radiologist is an important part of the medical team. Ninety-seven percent of them believed that having a grasp of general radiological concepts is essential for clinical practice. More than half of the participants (55%) believed that the amount of radiology teaching they receive is inadequate. Most students claimed to lack the radiological skills that a competent doctor should own, such as reading X-rays, CTs, and MRIs. Most students chose hospital-based and problem-based learning sessions as their most desired methods for radiology learning.

CONCLUSION

Radiology is an essential part of modern medicine. Adequate exposure to radiological techniques and adequate time to radiological teaching must be allocated to students during their undergraduate medical curriculum to improve the proper management of patients.

Association of health literacy and other risk factors with glycemic control among patients with type 2 diabetes in Kuwait: A cross-sectional study

BACKGROUND

Poor health literacy (HL) has received much attention recently as a risk factor for poor health outcomes especially among patients with chronic diseases. The degree to which HL affects health outcomes is unknown among patients with type 2 diabetes mellitus (T2DM) in Kuwait. This study aimed to investigate the association between HL and glycated hemoglobin (HbA1c) among patients with T2DM.

METHODS

356 patients with T2DM were selected from 27 primary care clinics covering the state of Kuwait. HL was measured by the Short Test of Functional Health Literacy in Adults (STOFHLA). Prevalence of uncontrolled HbA1c was estimated and its association with HL was modeled and tested using Poisson regression with log-link function and robust variance-covariance matrix, while adjusting for several confounders.

RESULTS

The prevalence of uncontrolled HbA1c was 77.8%. Among those with inadequate or marginal HL, about 50.7% have uncontrolled HbA1c. The prevalence of uncontrolled HbA1c among those on diet alone was 36.3% lower compared to those on mixed treatment regimen (APR = 0.637, 95% CI: 0.455-0.891, PV = 0.008). The prevalence of uncontrolled HbA1c among patients on oral hypoglycemic (OH) drugs alone was 22.3% lower compared to those on mixed treatment (OH plus Insulin) regimen (APR = 0.777, 95% CI: 0.697-0.865, PV < 0.001). For every one-year increase in age, there is 1.4% reduction in the prevalence of uncontrolled HbA1c (APR = 0.986, 95% CI: 0.978-0.994, PV < 0.001). For one STOFHLA score increase, there is 0.3% reduction in the prevalence of uncontrolled HbA1c (APR = 0.997, 95% CI: 0.994-1.00, PV = 0.055). Finally, for every year increase since T2DM onset, there is 1.1% increase in the prevalence of uncontrolled HbA1c (APR = 1.011, 95% CI: 1.003-1.019, PV = 0.008).

CONCLUSIONS

The prevalence of uncontrolled HbA1c among patients with T2DM in Kuwait is high. Half of T2DM with inadequate or marginal HL have uncontrolled HbA1c. Patients on diet alone or OH alone have lower prevalence of uncontrolled HbA1c compared to those on mixed treatment regimen. Older T2DM patients or those with higher STOFHLA score have lower prevalence of uncontrolled HbA1c, while those with longer T2DM onset have higher prevalence of uncontrolled HbA1c. Future interventions should focus on younger patients, improve HL, and establish better communications between physicians and patients with T2DM for better glycemic control.

Web-Based Health Information Seeking Among Students at Kuwait University: Cross-Sectional Survey Study

BACKGROUND

Owing to the revolution in technology, the internet has become an important aspect of people's lives. Modern technology is enabling people from diverse educational backgrounds to use the internet for several purposes, one of which is health information seeking. Recently, Web-based health information has become more popular among patients all over the world and among the general public.

OBJECTIVE

This study aimed to investigate the use of Web-based health resources among undergraduate students from different faculties at Kuwait University.

METHODS

The study employed a cross-sectional design with students selected from 8 faculties of Kuwait University, 4 faculties of Literature and 4 faculties of Science. Data were collected using structured questionnaires, and analysis was done using a chi-square test and binary logistic regression to determine the factors associated with seeking health information on the Web.

RESULTS

The sample size obtained was 1132 with a response rate of 90.27% (1132/1254). Overall, the prevalence of students seeking Web-based health information was 92.66%. (1049/1132) The most significant factors associated with seeking health information on the Web were age, gender, faculty, year of study, primary source of internet, and level of experience with internet use. In total, 90.0% (325/361) of students who were aged older than 21 years used Web-based health information compared with 82.8% (275/332) of those who were aged 18 years. In addition, female students showed a higher prevalence (829/934, 88.8%) of Web-based health information seeking than males (210/270, 77.8%). Students who majored in faculties of Science were more likely to seek health information than those who majored in faculties of Literature. All the differences found in the study were statistically significant (P<.05).

CONCLUSIONS

The study concluded that many people use the internet for seeking health information. Sociodemographic factors have a significant association with Web-based health information seeking. Therefore, doctors must educate the public about the health information websites that can be trusted.

Prevalence of health literacy and its correlates among patients with type II diabetes in Kuwait: A population based study

AIMS

The purpose of this study is to estimate the prevalence of health literacy among patients with type II diabetes and investigate its association with several covariates. No studies were conducted in the Arabian Gulf region characterizing such factors for this population.

METHODS

A cross sectional study was implemented in which 359 type II diabetes patients were recruited from diabetes centers across Kuwait. Health literacy was measured by STOFHLA. Multivariate linear regression was applied to investigate the relationship between health literacy and several covariates.

RESULTS

About 44.5% had inadequate, 19.5% marginal, and 35.5% adequate health literacy. Patients with inadequate health literacy were more likely to be older, females, widowed, low education, with income less than 500 KD/month. Multivariate linear regression indicated residence, nationality, education level, and age were significantly associated with health literacy. Adding marital status and gender, hierarchical linear regression revealed that 43.4% of the variability was accounted for.

CONCLUSION

Inadequate health literacy is high in Kuwait. Interventions should be implemented to improve health literacy. This will reduce the prevalence of diabetes-related complications, produce better diabetes outcomes, and improve patients' quality-of-life. Health literacy should be an integral part to health promotion and chronic diseases' management programs in Kuwait.

The readiness of hospital pharmacists in Kuwait to practise evidence-based medicine: a cross-sectional study

BACKGROUND

The evolving role of pharmacists in providing pharmaceutical care, as part of the healthcare team, challenges them to acquire up-to-date knowledge of medicines to make the best clinical decisions. The volume of medical literature is on the increase, and it is important to utilise these resources to optimise patients' therapeutic outcomes. This study aimed at assessing the readiness of government hospital pharmacists in practising evidence-based medicine (EBM) in Kuwait in regards to their attitude, knowledge and skills, as well as the perceived barriers and facilitators.

METHODS

This descriptive cross-sectional study used pre-tested self-reported questionnaires to collect information from pharmacists working at government hospitals in Kuwait. In addition, one-to-one, face-to-face semi-structured interviews were conducted with the chief pharmacists of all health regions in Kuwait to discuss and identify the barriers and facilitators of implementing EBM in the hospitals. Quantitative and qualitative analytical measures were undertaken for the data acquired from the questionnaires and interviews, respectively.

RESULTS

A total of 176 pharmacists (of 445) working in secondary and tertiary government hospitals in Kuwait agreed to take part in the study, giving a response rate of 40%. Over half of the study sample (n = 94, 53.4%) had good confidence in performing online database searches. Approximately 50% of the pharmacists were familiar with searching the Internet for medical resources, asking answerable clinical questions and retrieving research evidence. However, 67% of the pharmacists (n = 118) were neither able to apply research evidence to patient care nor capable of identifying knowledge gaps in practice. Barriers to EBM practice were identified, which included limited access to EBM resources (75%), a lack of time and patient overload (71.6%). The interview results confirmed the willingness of the hospital pharmacists to adopt EBM in their practice if necessary resources such as computers and internet connection were provided.

CONCLUSION

The hospital pharmacists in Kuwait showed good attitude and willingness towards EBM, however, they need to acquire adequate knowledge and skills for applying it in "real life" practise. Using the current results, clinical implications were recommended to demonstrate how to overcome the barriers, wherein hospital pharmacists could be ready to practice EBM.

Changes in the diameter and valve closure time of leg veins in primigravida women during pregnancy

OBJECTIVE

The aim of this study was to monitor the changes that develop in leg veins of primigravida women during pregnancy.

METHODS

Sixty primigravida women volunteered to undergo clinical evaluation and duplex ultrasound examination of both lower limb veins to monitor changes in vein diameter and valve closure time (VCT) during pregnancy and 3 months postpartum by duplex ultrasound. A total of four readings were taken for each subject, one reading for each trimester and the last reading at 3 months postpartum.

RESULTS

The mean (± standard deviation) age of participants was 26.82 ± 2.47 years; 39 limbs (32.5%) and 65 limbs (54.2%) developed C1-C3 venous changes during the second and third trimesters, respectively. Three months post partum, 36 limbs (30%) continued to have C1-C2 changes. Only four limbs in four subjects developed varicose veins along the great saphenous vein, and their VCT was more than 1 second. These subjects were found to have a family history of varicose veins. Duplex examinations showed that there was a gradual increase in the diameter and VCT from the second trimester through the third trimester of pregnancy in all examined venous segments. These changes were statistically significant by Friedman and related-samples Wilcoxon signed rank tests within the same legs (P = .001) but not between legs in the same subject (P > .05), even with adjustment for body mass index (P = .001-.049).

CONCLUSIONS

In primigravida women, lower limb veins showed gradual increase in vein diameter and in VCT starting from the second trimester. These changes reverted to baseline in most cases 3 months after delivery.

Changes in the diameter and valve closure time of leg veins across the menstrual cycle

OBJECTIVES

The purpose of this study was to determine the changes (if any) in the diameter and valve closure time of the lower limb veins in healthy young nulliparous women at different phases of the menstrual cycle.

METHODS

Fifty-three young nulliparous women were asked to undergo clinical evaluations and duplex ultrasound examinations of both lower limb veins to monitor changes in the vein diameter and valve closure time at different phases of their menstrual cycles. The vein diameter on B-mode imaging and valve closure time on pulsed Doppler tracing were calculated at days 1 to 4, 14 to 16, and 25 to 28 of the menstrual cycle. Freidman and related samples Wilcoxon signed rank tests were used to determine time-related changes in venous function.

RESULTS

The volunteers' mean age ± SD was 20.60 ± 1.90 years, and their mean body mass index was 23.90 ± 4.90 kg/m(2). There was a gradual increase in the vein diameter and valve closure time at the specified phases of the menstrual cycle. Friedman and related samples Wilcoxon signed rank tests for venous segment diameter and valve closure time changes between the different phases of the menstrual cycle were performed and showed statistical significance for each venous segment within each limb (P = .003-.025). Also, when adjusted for body mass index, statistical significance existed for the same venous segments in the same limbs (P =.001-.049). There was no statistical significance for the same venous segments at the same phase of the menstrual cycle between limbs (related samples Wilcoxon signed rank test: P =.079-.97).

CONCLUSIONS

During the menstrual cycle, the lower limb veins show an increase in their diameter and valve closure time. These changes are probably mediated by the female sex hormones.