Australasian Medical Journal
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The opinion of family medicine residents in Saudi Arabia on breastfeeding education in their curriculum: A qualitative study using focus groups
Get PDFBackgroundBreastfeeding is the natural way of feeding babies; it has many health benefits for mothers and their babies. Mothers can face some challenges during the process of breastfeeding, which, if not addressed by a physician with specific knowledge and expertise, could lead to the cessation of breastfeeding.Globally, breastfeeding education in the Family Medicine residency curriculum receives minimal attention for several reasons; some are related to the residents and other stakeholders, and some to financial aspects.AimsThe objective of this study is to explore the Family Medicine residents' opinions regarding the potential introduction of breastfeeding education to their curriculum.Methods In this exploratory qualitative study, data were gathered using focus groups of Family Medicine residents working within Primary Health Care centers in Saudi Arabia. Data were analysed using an iterative thematic approach.Results Thirteen Family Medicine residents participated in the focus group. Three main themes were generated: Breastfeeding background and experience, the experience of breastfeeding education, the introduction of breastfeeding medicine aligned with residents’ opinions. Residents acknowledge the lack and the inconsistent implementation of breastfeeding education in their curriculum; they acknowledge its importance. Residents are open to learning about breastfeeding to improve their practice, provided clear methods of teaching and evaluation exist. Residents highlighted the challenges that can face the implementation of such a program and possible solutions from their perspective.ConclusionThis study could raise the awareness of decision-makers about breastfeeding education and supports the introduction of a national-level policy to integrate it into Family Medicine residency programs in Saudi Arabia
Patient perception and attitudes toward magnetic resonance imaging safety
Get PDFBackgroundMagnetic resonance imaging (MRI) scanners use strong, static and fast magnetic fields to form images. Due to rapid developments in MRI technology, several accidents have been recorded in hospitals worldwide as a result of insufficient knowledge about the dangers of MRI on the part of the patient or a failure to follow safety guidelines. This study evaluates patients’ perception and attitudes about MRI safety.AimsThis is a cross sectional study to evaluate the perception and attitudes of patients regarding MRI safety procedures.MethodsA 21 items questionnaire was collected from 119 patients in the MRI waiting area before the commencement of examination. Data were analysed using Statistical Package for the Social Sciences (SPSS) software (version 22.0, IBM Corp, Armonk, New York). The odds (OR) and 95 per cent confidence interval (CI) were used for analysis, the level of significance was set at p=0.05 using Chi-Square test to evaluate the relationship among the variables in the questionnaire.ResultsThe responses were collected from the patients and their relatives (46 male (38.6 per cent) and 73 female (61.4 per cent)). Approximately 71 per cent of the participants have already read or heard about MRI and the related safety aspects. 76 per cent of overall participants stated that they are aware of the need for preparation before an MRI exam with more awareness of MRI safety issues among younger patients (88 per cent). In this instance, females showed a higher level of knowledge (26 per cent) compared to males (11 per cent) with p=0.035.ConclusionPatients reported insufficient information about MRI safety which may increase the potential for accidents
The Association between Body Dysmorphic Disorder (BDD) and Acceptance of Cosmetic Surgery Scale (ACSS): A nationwide study from 25 medical schools
Get PDFBackground: Body dysmorphic disorder (BDD) is a psychological condition that is characterized by obsessive thinking about a perceived flaw in one's appearance that may eventually cause significant distress and impairment in life.Methods: A cross-sectional study was conducted between January 2021 and August 2021 using a previously validated and published questionnaires — The Body Image Disturbance Questionnaire (BIDQ) and Acceptance of Cosmetic Surgery Scale (ACSS). Distributed to all medical students from 25 universities across all regions of Saudi Arabia. Results: A total of 1,776 respondents completed the questionnaire. Females represented 57.1% of the study population.More than half of the respondents were concerned and preoccupied with their body appearance (59.4% and 52.8%, respectively). The average of the BIDQ and ACSS scores was significantly higher in females compared to males, while higher socioeconomic status and higher educational level were also significantly related with higher BIDQ and ACSS scores. Furthermore, a higher BIDQ score was associated with higher scores on the ACSS
Prevalence and outcome of newly diagnosed diabetes in COVID-19 patients: A systematic review
Get PDFBackgroundPatients with COVID-19 with diabetes mellitus (DM) are reportedly more likely to develop severe clinical course and increased mortality.AimsWe aimed to investigate the prevalence of newly diagnosed DM in COVID-19 patients and observe the association of underlying DM with increasing incidence of serious adverse events and mortality in COVID-19 patients.Methods We searched PubMed/Medline, Cochrane, Google Scholar, and Embase/Ovid for relevant articles that match our inclusion criteria. We assessed the quality of studies using the National Heart, Lung, and Blood Institute Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Our outcomes of interest were mainly the prevalence of ICU admissions and mortality.Results The pooled proportion of newly diagnosed DM in hospitalized COVID-19 patients was 44.5 per cent. We report that newly diagnosed diabetics indicate a poor prognosis of COVID-19 compared with non-diabetics or previously-known DM. We also show that COVID-19 patients with newly diagnosed DM are at increased risk of getting ICU admissions compared with patients with pre-existing DM.ConclusionWe show that 44.5 per cent of hospitalized COVID-19 patients are likely to develop DM. We also confirm that DM worsens the prognosis of COVID-19 patients and raises the incidence rates of both ICU admissions and mortality
A brief overview of learning theories in medical education: Using dental trauma as an example
Get PDFThe literature identifies that medical student receive little or no formal dental trauma assessment and management teaching during medical school. To bridge this important gap in medical education, medical educators should look to introduce basic dental trauma teaching into undergraduates’ final year of medical school. To set up a solid foundation for long-term learning, educators should consider which theories are most suited to transfer knowledge effectively to students in particular contexts. Similarly, medical educators should consider which theory or hybrid of learning theories best fits their teaching goals. In the absence of a dental educator at the medical school, offering an online learning approach is an ideal solution for filling medical students’ knowledge gap in assessing and managing dental trauma injuries
Medication induced transient myopic shift
Get PDFA 30-year-old female presented two days post myomectomy with blurred vision due to myopic shift. She was found to have a shallow anterior chamber with normal intra-ocular pressures and no uveal effusion. This was thought to be medication induced and after suspending celecoxib her vision improved back to baseline
Biomarkers of severity and outcome among adult COVID-19 positive patients admitted to a tertiary referral hospital
Get PDFBackgroundSeveral biomarkers were found to predict the severity and outcome of COVID-19 infection.AimsTo determine the associations between laboratory biomarkers with COVID-19 severity and outcome.MethodsA prospective study among confirmed COVID-19 patients aged 18 years old and above for biomarkers, and correlated with severity and mortality.ResultsOf 347 patients, 245 (70.6 per cent) were RT-PCR COVID-19 positive. Patients who were admitted to the ICU had higher levels of WBC count, lymphocytes, neutrophils, N/L ratio, D-dimer, potassium, phosphates, ferritin, CRP, ESR and cortisol, whereas patients who died were older, and had higher levels of N/L ratio, D-dimer, potassium, phosphates, ferritin, CRP, procalcitonin, cortisol, FBS, HbA1c, PTH and number of comorbidities compared to those who survived. Cortisol, FT3, and FBS were the most significant predictor for mortality and ferritin for ICU admission.ConclusionHigh cortisol and blood sugar and low FT3 were associated with higher mortality whereas low haemoglobin and lymphocytes and high N/L ratio, ferritin and D-dimer were associated with ICU admission among COVID-19 (+) patients. The first day biomarkers may provide clues for the eventual outcome and severity among COVID-19 patients. This will facilitate a more focused and aggressive intervention and early ICU admission
Serum cortisol as a predictor of major adverse outcomes in patients with COVID-19
Get PDFBackgroundSeveral biomarkers were found to predict the severity and outcome of COVID-19 infection.AimsTo determine the serum cortisol response in patients with Coronavirus Disease 2019 (COVID-19) and its correlation with disease outcomes.Methods A prospective study among confirmed COVID-19 patients aged 18 years old and above. Morning cortisol levels were measured within 24 hours of admission. Relationship between cortisol levels and outcomes (intensive care unit (ICU) admission, intubation, and death) were analysed.Results A total of 206 patients positive for COVID-19 (mean age of 53.6±15.2 years) were included in the study. Mortality was recorded in 21 (30.4 per cent) patients with cortisol levels of ≥570nmol/L, 6 (8.8 per cent) among patients with 181–569nmol/L cortisol level, and 8 (11.6 per cent) among patients with ≤180nmol/L cortisol. Patients with cortisol levels of ≥570nmol/L were more likely to be admitted to the ICU, be intubated and longer hospital stay. Serum cortisol and ferritin levels were the most significant predictors of mortality. ConclusionOn admission, the morning cortisol level was predictive of mortality, ICU admission, intubation, and length of hospital stay in patients with COVID-19 and may be listed as an independent predictor for worse outcomes of COVID-19 infection
Coronary Artery Bypass Grafting (CABG) versus Percutaneous Coronary Intervention (PCI) in treatment of left main coronary artery disease
Get PDFBackgroundCoronary artery bypass graft surgery (CABG) has been widely used for left main coronary artery disease (LMCAD). Percutaneous coronary intervention (PCI) has become an option for this condition.AimsTo summarize the current evidence that compare between CABG vs. PCI in regards to cardiac death, stroke, and myocardial infarction.Methods We searched randomized trials of treatment of LMCAD with PubMed, Google Scholar, and EBSCO.Results Five randomized studies were retrieved, which compared the efficacy between CABG vs. PCI in treatment of LMCAD.ConclusionPCI may be reasonable management of patients with LM stenosis involving distal bifurcation or with coexisting multivessel disease