Assessment of mental health and various strategies among Health Professions' (HP) students: A cross sectional study in King Saud Bin Abdulaziz University for Health Sciences

BACKGROUND

The education environment of medical colleges is known to have a burdensome effect on the overall mental health of the students. This study aimed to investigate the immediate impact of the medical education environment on mental health and quality of life among Health Profession students and to identify various coping strategies used by students to mitigate the stress.

MATERIALS AND METHODS

An online survey was conducted between April 1 and May 10, 2021, using a validated questionnaire based on DASS-42, employing a snowball sampling technique.

RESULTS

A total of 338 students filled the questionnaire. The respondents had a high level of depression and anxiety scores, categorized as very severe which were significantly different among level of education (P < .05), for example, 88.9% of sixth year students had very severe depression compared to just 37% of first year ones. Gender-wise very severe scores varied from lowest 45.8% to 70.3% with comparable results for both males and females. Additionally, more than 30% of the students listed that the amount of material to be covered, lack of time to study the material to be tested, heavy demand to study, concern about trying to learn all the content, and competitiveness among students to be the top reason which affect their mental state of mental health.

CONCLUSIONS

This study identifies the need to provide the free professional and psychological services to help cope with stress to the health profession students.

Assessment of Auscultation Skills Among Junior and Senior Healthcare Providers for Pediatric Patients: A Retrospective Study

Background

Heart murmurs are defined as whooshing or swishing sounds, unlike the normal lub-dub sounds detected by physicians while using a stethoscope. They usually develop due to numerous pathologies, with congenital defects accounting for the majority of pediatric murmurs. Few studies have addressed the difference in auscultating skills between senior and junior healthcare providers. Therefore, this study aims to collect local data on this topic as well as identify the gap between experienced and inexperienced providers in their ability to accurately detect heart murmurs.

Methodology

This study utilizes a quantitative retrospective design to collect data from King Abdulaziz Medical City and King Faisal Cardiac Centre, Saudi Arabia, from October 1, 2018, to September 30, 2019. The medical records of 292 pediatric patients, who were 14 years of age or below according to the centers’ aging system, were collected from the Hospital Information System (BESTCare). Subsequently, it was determined whether a senior (R3-R4 residents and above) or a junior (R1-R2 residents and interns) healthcare provider ordered an echocardiogram (ECHO). Finally, using the centers’ imaging system (Xcelera) the exact reason for referral, heart murmurs in the case of this study, was obtained, as well as whether a pathologic cause of a murmur was seen in the ECHO image. By obtaining the aforementioned data, the accuracy of each referral was analyzed using statistical analysis software.

Results

ECHO results were categorized into positive and negative outcomes depending on the presence of a structural heart defect, patent foramen ovale (PFO) was considered negative as it causes innocent murmurs. The majority of positive results were atrial septal defects, patent ductus arteriosus, and ventricular septal defects. The majority of negative results were either a structurally normal heart or PFO, which a great number of providers ordered an ECHO for. The Pearson score p-value using the chi-square test was 0.432, leading to the conclusion that junior and senior providers had a similar accuracy of referrals during the study period.

Conclusions

Junior healthcare providers display sufficient knowledge of heart murmur auscultation skills similar to senior healthcare providers during the study period. However, because the data only included two local centers with a limited sample and the absence of further local research on this topic, it is necessary to conduct studies of a larger scope on this topic.

The Association Between Vitamin D Serum Level and COVID-19 Patients’ Outcomes in a Tertiary Center in Saudi Arabia: A Retrospective Cohort Study

Vitamin D deficiency has been associated with the risk for immune-mediated inflammatory reactions in various respiratory infections. Our study investigated the association between vitamin D deficiency and coronavirus disease 2019 (COVID-19) patients’ outcomes. We included 545 patients who were admitted to a tertiary center in Jeddah, Saudi Arabia from March 2020 to July 2021 with a vitamin D serum test result at the time of infection or prior to disease onset. The data were extracted retrospectively using a data collection sheet. Our primary outcomes were intensive care unit (ICU) admission and in-hospital mortality. The cut-off values for vitamin D were <25, 25-49, and 50-250 for deficient, suboptimal, and optimal levels respectively. Our result revealed that there is no association between vitamin D serum levels deficiency and ICU admission (OR=1.08, p=0.75) or in-hospital mortality (OR=1.74, p=0.97). ICU admission and in-hospital mortality percentages in patients with vitamin D deficiency were 14.1% and 6.4%, respectively. In comparison, percentages for patients with optimal levels were 16.67% and 6.15% for ICU admission and in-hospital mortality, respectively. Smoking was not associated with ICU admission (p=0.05) or in-hospital mortality (p=0.38). Our study does not support a relationship between vitamin D deficiency and COVID-19 patients’ outcomes. Future studies should be directed toward conducting randomized clinical trials to determine whether vitamin D has an effective role in reducing COVID-19 severity.

Pediatric Inflammatory Bowel Disease Associated With Celiac Disease: A Retrospective Study in a Tertiary Care Hospital in Saudi Arabia

Background. Inflammatory bowel disease (IBD), which includes ulcerative colitis (UC) and Crohn’s disease (CD), is a chronic relapsing disease indicated by inflammation of the gastrointestinal tract. Celiac disease (CeD) is a chronic autoimmune disease of the small bowel. The prevalence of CeD in IBD patients is unknown. Some studies have described the coexistence of the 2 diseases in the same patient. This study aimed to investigate the prevalence of CeD in Saudi Arabian children with IBD. Methods. We used a retrospective study design because data can be collected immediately and is easier to analyze afterward. The study was conducted on IBD patients in the Pediatric Gastroenterology Department at National Guard Hospital, Jeddah, Saudi Arabia. We enrolled Saudi patients aged between 1 and 18 years who had been diagnosed with IBD and CeD based on positive biochemical serology and histology from January 2011 to January 2020. We excluded patients with immunodeficiency disorders. Results. Among the 46 enrolled patients with IBD, CeD was identified in 4, and they did not develop any relapses. We discovered that the weight at IBD diagnosis improved significantly compared to current weight (P-value < .0001). We also discovered that the height at diagnosis of IBD improved significantly compared to the current height (P-value < .0001). Additionally, we found no significant associations between UC and CeD (P-value = 1), or CD and CeD (P-value = .625). Conclusion. No significant associations were evident between the prevalence of CeD and IBD. More prospective multicenter studies are needed to clarify the prevalence of CeD in children with IBD.

Introducing free response short answer questions in anatomy spot tests: experiment study

PURPOSE

A spot test is commonly used to assess practical knowledge through a series of specific questions related to the marked anatomical structures on cadavers. However, the continuous reviewing and developing of the medical curricula demands the need to improve the assessment method of the practical examination of anatomical knowledge. Therefore, the aim of the study was to examine the effectiveness of a free response short-answer questions (FRSAQs) test and traditional questions on medical students' performance.

METHODS

This is an experimental study using a Randomized Posttest-Only Control Group Design to compare the mean of students' performance in addition to their perceptions about the two versions of the spot tests. Two hundred and ninety preclinical-year medical students were invited to participate in this study.

RESULTS

Only 109 (38%) students participated in this study. The data analysis showed a significant improvement in students' performance in the FRSAQs test (5.3 ± 2.7) than the traditional spot test (4.7 ± 2.6), (P = 0.04). The majority of the students (70%) preferred the FRSAQs spot test, citing that it is good test to assess practical knowledge. The psychometric analysis revealed that the FRSAQs produced more ideal stations (60%) when compared to the traditional spot test (10%).

CONCLUSION

The current study found that the FRSAQs spot test had a significant impact on students' performance, and it was considered an ideal, flexible, and stress-free assessment method when compared to the traditional spot test. Implementation of the strategy in teaching and in assessment is recommended.

The anterior talofibular ligament: A detailed morphological study

The anterior talofibular ligament (ATFL) is commonly injured and may result in ankle instability. Good results from ATFL reconstruction have been reported; however complications and movement restrictions have also been observed. ATFL differences have been reported; however details of its precise bony attachment are lacking. This study provides a detailed morphology of the ATFL with respect to surgical and clinical applications. ATFL morphology, number of bands and the exact insertion points were studied in 50 formaldehyde embalmed feet. ATFL length was measured in different joint positions to assess its functional role: ATFL length varied from 18.81 mm in dorsiflexion to 21.06 mm in plantarflexion: mid-length width and thickness were 4.97 mm and 1.01 mm respectively. The bony attachment lengths were also measured: mean proximal and distal bony attachment lengths were 4.68 mm and 3.1mm respectively, while 13.04 mm had no bony attachment. One (22.9%), two (56.3%) and three (20.8%) band morphologies were observed originating 10.37 mm anterosuperior to the lateral malleolar tip and inserting 3.92 mm anterior to the anterior lateral malleolar line (ALML). Detailed morphology of the ATFL may help in restoring injured ATFL function by appropriate ligament reconstruction, as well as aid the understanding of the mechanism of ligament injury.