First national survival data for colorectal cancer among Saudis between 1994 and 2004: what’s next?

Abstract Background Colorectal cancer (CRC) is the second most common malignancy in the Saudi population. This study aimed to review CRC data from the Saudi Cancer Registry (SCR) in order to evaluate the prognostic factors for CRC survival in Saudi patients. Methods This study was a retrospective censored overall survival (OS) analysis of CRC data for the period 1994–2004 obtained from the SCR. Data were collected from all 13 administrative regions of the Kingdom of Saudi Arabia (KSA) by the SCR in collaboration with the National Information Center of the Ministry of Interior. The Kaplan-Meier method was used to calculate the cumulative survival rate, which was then stratified by gender and by period (1994–1999 versus 2000–2004). The clinico-pathological variables that might affect CRC survival were analyzed by Cox regression analysis. Results Between 1994 and 2004, 549 CRC cases were diagnosed (363 [66.1%] in males and 186 [33.9%] in females). The OS for CRC during this period was 44.6% (44.7% for 1994–1999 and 44.3% for 2000–2004 [p=0.7]). There was a significant (p=0.003) discrepancy of 9.6% between the male five-year OS (41.0%) and the female five-year OS (50.6%). The five-year OS was 63.3% for patients with localized disease, 50.2% for those with regional disease, and 14.7% for patients with metastases. By Cox regression analysis, age and extent were significant prognostic factors of survival in patients with colon cancer; the risk was higher in patients with distant metastasis (hazard ratio [HR], 2.53; 95% confidence interval [CI], 1.17-5.45; p=0.01). In patients with rectal cancer, the risk was lower in males (HR, 0.66; CI, 0.45-0.98; p=0.04), but higher in patients with unknown tumor extent (HR, 3.70; 95% CI, 1.66-8.24; p=0.01). Conclusions The five-year OS for 1994–2004 was 44.6% for patients with CRC. More so, five-year OS based on CRC stage was generally lower than the typically reported survival rates. The establishment of a national screening program and increased access to specialized medical faculties may be necessary to improve CRC survival in the KSA.</p

Effect of Pegylated Interferon on Non-Responders and Relapsers with Interferon

Objectives: To assess whether a combination of pegylated interferon (interferon conjugated with polyethylene glycol) and ribavirin can improve the response rate in patients with chronic hepatitis C who either did not respond to (Non-responders), or had relapsed after responding to (Relapsers) standard interferon and ribavirin combination therapy. Patients and methods: In this prospective study, 20 chronic hepatitis C patients (comprising 16 Non-responders and 4 Relapsers to previous treatment with alpha interferon and ribavirin), were treated with pegylated interferon-2b weekly and ribavirin daily for one year. Eleven patients had genotype 4, eight were of genotype 1 and one patient had genotype 3. Response to treatment was determined based on normalisation of liver enzymes and negative viral load (assessed using qualitative HCV RNA PCR) at end of treatment (ETR) and 6 months off treatment (SVR). Results: Seven patients (35%) achieved normalisation of liver enzymes and negative viral load at the end of treatment. However, only 2 patients (10%) managed to retain these levels after six months off treatment. The latter two patients had been previous Relapsers. Conclusion: Combination of pegylated interferon and ribavirin may be beneficial in previous relapsers with standard interferon-ribavirin combination therapy, but is unlikely to achieve sustained virological response in non-responders.

Health rights knowledge among medical school students at King Abdulaziz University, Jeddah, Saudi Arabia.

Health care is a basic human right, and Saudi Arabia affirms these rights for all its citizens.To assess the knowledge of medical students regarding health rights in Saudi Arabia.This cross-sectional study was conducted at King Abdulaziz University (KAU) from September 2015 through November 2015. A questionnaire written in English collected demographic data and included questions about reproductive health care and health rights of women and patients with cancer, senility, or special needs.Of the 267 participants, 184 (68.9%) were female, and 252 (94.4%) were Saudi. Regarding consent, 87 (32.6%) and 113 (42.3%) participants believed a female patient required the consent of a male guardian to receive medical treatment or surgery, respectively, in Saudi Arabia, and only 106 (39.7%) knew that a female patient could provide consent for a caesarean section. Sixty-six (24.7%) believed that abortion is never allowed in Islam. Only 93 (34.8%) were aware that acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV) patients had health rights, about half (144, 53.9%) knew that cancer patients have a right to full information, and most (181, 67.8%) believed that a patient had the right to withhold health information from his/her family. Approximately half were aware that cancer patients have the right to free medical treatment (138, 51.7%) or that health rights applied to special needs patients (137, 51.3%) and senile patients (122, 45.7%).The knowledge of KAU medical students regarding health rights of certain patient populations highlights the importance of health rights education in medical school

An explanatory mixed methods study on the validity and validation of students’ assessment results in the undergraduate surgery course

<p><b>Background/purpose:</b> There is inadequate evidence of reported validity of the results of assessment instruments used to assess clinical competence. This study aimed at combining multiple lines of quantitative and qualitative evidence to support interpretation and use of assessment results.</p> <p><b>Method:</b> This study is a mixed methods explanatory research set in two stages of data collection and analysis (QUAN : qual). Guided by Messick’s conceptual model, quantitative evidences as reliability and correlation coefficients of various validity components were calculated using students’ scores, grades and success rates of the whole population of students in 2012/2013 and 2013/2014 (<i>n</i>= 383; 326). The underlying values that scaffold validity evidences were identified via Focus Group Discussions (FGD) with faculty and students; sampling technique was purposive; and results were analyzed by content analysis.</p> <p><b>Results:</b> (1) Themes that resulted from content analysis aligned with quantitative evidences. (2) Assessment results showed: (a) content validity (table of specifications and blueprinting in another study); (b) consequential validity (positive unintended consequences resulted from new assessment approach); (c) relationships to other variables [a statistically significant correlation among various assessment methods; with combined score (0.64–0.86) and between mid and final exam results (<i>r</i> = 0.672)]; (d) internal consistency (high reliability of MCQ and OSCE: 0.81, 0.80); (3) success rates and grades distribution alone could not provide evidence to advocate an argument on validity of results.</p> <p><b>Conclusion:</b> The unified approach pursued in this study created a strong evidential basis for meaningful interpretation of assessment scores that could be applied in clinical assessments.</p

Medical students’ knowledge of the health rights of cancer patients in Saudi Arabia.

<p>Medical students’ knowledge of the health rights of cancer patients in Saudi Arabia.</p

Medical students’ knowledge of the rights of female patients in Saudi Arabia.

<p>Medical students’ knowledge of the rights of female patients in Saudi Arabia.</p

Male and female medical students’ knowledge of reproductive health rights in Saudi Arabia¹.

<p>Male and female medical students’ knowledge of reproductive health rights in Saudi Arabia<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0176714#t006fn002" target="_blank">¹</a>.</p

Male and Female medical student’s knowledge of the rights of female patients in Saudi Arabia¹.

<p>Male and Female medical student’s knowledge of the rights of female patients in Saudi Arabia<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0176714#t005fn001" target="_blank">¹</a>.</p