Perception of Faculty Members of Regional Medical School Toward Faculty Development Program

Introduction: Any types or process of activities that are performed by a group or an individual to enhance, promote, and improve the performance, competencies or skills of a health professional at an institute level are defined as faculty development which has many other names like staff development, academic development, and educational development. The importance of faculty development stressed by Harden is equivalent to curriculum development, which is a very difficult assignment. Objectives: To determine the pattern of faculty members’ perception toward their weekly faculty development program. Methodology: Enrolling the faculty members of the College of Medicine, University of Bisha, Kingdom of Saudi Arabia ( COM/UB,KSA). COM/UB adopting the innovative curriculum (problem-based learning, team-based learning, interactive lectures, and case-based learning and seminars. Each Tuesday, faculty members gather in the faculty development academic program (FDAP) room to discuss issues related to medical education and quality. Usually, there is a presentation on the selected topic over 25 min, followed by a discussion and workshop, and finally, a recommendation is drawn. The inclusion criterion is those staying in the college for a period of more than one year. New joiners and those staying for a period of less than one year were excluded. Faculty members were enrolled optionally and requested to fill a validated questionnaire. Results: The response rate was 92% of total staff. More than 89%, 87%, 86% and 74% thought that the FDAP is useful to them, helps them in addressing academic issues in the faculty, is an enriching experience, and thought that it helps them in constructing high-quality multiple choice questions (MCQs). Finally, 84% were interested in presenting topics in FDP. Conclusion: FDAP was positively perceived by the faculty members of the University Bisha/College of Medicine, since it enriches their experience and satisfies their academic job. Keywords: faculty, development, academic, program, MCQ

Overview on Epidemiology and Management of Myxedema Coma or Crisis

The most severe type of hypothyroidism is known as myxedema coma, which can quickly lead to death if not identified and treated aggressively. The condition known as hypothyroidism is easily detected and treated. But if ignored, it might eventually progress to myxedema coma, the most serious form of hypothyroidism. Since the majority of patients do not initially appear in a coma, the term "myxedema coma" is usually regarded as misleading. Lethargy usually progresses to stupor, which then becomes a coma with hypothermia and respiratory failure. only clinical criteria are used for diagnosis because thyroid hormone assays are unable to distinguish between simple hyperthyroidism and thyroid storm. Apart from essential medical interventions, the treatment focuses on preventing thyroid hormone production and secretion as antithyroid medications, and preventing the peripheral effects of thyroid hormone as β-blocker, glucocorticoids. The diagnosis of thyroid-stimulating hormone (TSH) in the blood is the same as that of simple hypothyroidism. As soon as a diagnosis is obtained, treatment should start right away. The majority of hospital and commercial laboratories can turnaround a TSH test in a matter of hours

Barriers in the Implementation of Clinical Guidelines in Diabetes Management: Physicians’ Experiences in Bisha, Saudi Arabia

Introduction: Currently, the number of people living with diabetes in Saudi Arabia is less than one in every ten individuals and this number is expected to double in the next 20 years, which entails frequent and thorough investigation of implementation and effectiveness of the disease management guidelines. Aim: To explore the knowledge and barriers in implementation of the clinical guidelines in diabetes management among the physicians in Bisha, Saudi Arabia. Materials and Methods: In this cross-sectional study, data were collected using structured questionnaire, from a convenient sample of 149 physicians working at several health centers in Bisha, Saudi Arabia from May 2021 to July 2021. The implementation of clinical guidelines according to physician’s gender, years of experience, specialty, workplace, and professional status was statistically assessed using Mann-Whitney test, Chi-square test, Kruskal-Wallis test and Spearman test. The data was imported to an Excel sheet, coded and analysed using Statistical Package for Social Sciences (SPSS) (IBM version 20). Results: The results showed no significant relationship between guideline use and assessed variables except for years of experience, indicating that work experience influences practitioners’ impressions and attitudes towards clinical guidelines (0.001). The study also disclosed some barriers to implementing the clinical guidelines, including lack of familiarity (mean=3.483; median=4) and awareness (mean=3.637; median=4). The results also showed that the minor challenges included a lack of confidence in guideline developers (mean=2.557; median=2), lack of outcome expectancy in patient care (mean=2.7114; median=2) and a lack of agreement with guidelines because they were not up to date (mean=2.591; median=2). Conclusion: The findings concluded that physicians were well aware of the American Diabetes Association standards, demonstrating their popularity and ease of use in Saudi Arabia

Experience of the health promotion clinics in Aseer region, Saudi Arabia

Context: Health promotion is the most important element of primary health care. Therefore, it is essential for the health team to apply such activity. Objective: To describe a newly established health promotion clinic at primary health care centers, in Abha city, KSA. Materials and Methods: The study was conducted during the year 2009. The files of 429 individuals were reviewed after one year from attending the health promotion clinics in Abha city, KSA. Master sheet was designed based on the relevant items of the file. The health promotion services used in the study were based on the recommendation of the relevant guidelines. Data entry and analysis was carried out using Statistical Program for the Social Sciences (SPSS). P-values less than 0.05 were selected for statistical significance. Results: After one year, the percentage of the individuals who intake imbalanced diet and did not perform any type of physical activity was more than 90% while 8% are currently smokers and 14% had depression. Clinical examination and investigation revealed that more than one quarter of our subjects were overweight. Obesity was 42% in males versus 51% in females (P<0.04). Pre-hypertension and hypertension were detected among 44 and 12% respectively. About one fifth of our subjects had pre-diabetes 21% and 3% were confirmed to have diabetes mellitus. Diet and physical activity counseling was given to all participants while referral to concerned clinics was done for individuals who suffer from high blood sugar, abnormal lipid profile, obesity and depression. Conclusion: This study demonstrated that health promotion clinics provided by trained professional health care team can be used as a new approach for early detection and management of the common health problems in primary health care centers

Hypertension care in Aseer region, Saudi Arabia: Barriers and solutions

The aim of this study is to assess the current situation of hypertension (HTN) care, to explore the barriers and to suggest the practical solutions to improve the quality of HTN care in primary health care centers (PHCC) in the Aseer region, KSA. This cross-sectional study was conducted in PHCCs in this region in 2010. Data collection sheets used to achieve the aims of this study consisted of three checklists, the first one derived from the quality assurance manual and HTN records used at the PHCCs giving details of the structural base of HTN care. Satisfaction with HTN care was assessed by using a five-point Likert scale questionnaire, while the third part was assessed by a checklist designed for the HTN care processes. Data were coded, entered and analyzed using SPSS version 16. The total number of HTN patients registered at PHCCs in Aseer region was 23,156 patients. Of them, 15,942 (69%) had files at PHCCs. Most of the essential infrastructures were acceptable, except training of doctors and nurses on HTN, which were 75% and 89%, respectively. About 40% of patients were on Beta blockers or ACE inhibitors and 30% were being given Aspirin in addition. HTN was uncontrolled among 45% of patients, while the defaulter rate was 22%. The rates of complications ranged from 0.7% for stroke to 7% for ischemic heart diseases. It was found that more than one-third of the patients had obesity and diabetes, while 10% suffered from dyslipidemia. Health teams were unsatisfied with the community participation (43%), patient compliance with appointment (32%) and coordination with hospitals (20%). They were satisfied with the health team (85%), while satisfaction with other items ranged from 60% to 75%. This study revealed that HTN patients received insufficient care, which could be attributed to many different barriers. In order to improve the quality of HTN care for HTN, these barriers should be overcome by implementation of the recommendations

Evaluation of Smart Chromatic Technology for a Single-Shade Dental Polymer Resin: An In Vitro Study

The aim of the study was to assess the color matching ability and color stability of a single-shade resin-based composite (Omnichroma—OM) in comparison to a conventional dental composite. One hundred and sixty lower molar acrylic teeth in four different shades (B1, B2, A3, and C3) were prepared with class I cavities. Eighty teeth were divided into two groups based on the two resin composite materials (OM and Filtek Z-350 (FT)) for cavity restoration. Three groups were included in the color matching assessment, namely Gp 1-FT, Gp 2-OM-light cured (C), and Gp 3-OM-uncured (UC) groups. The color assessment was performed prior to cavity restoration and after cavity filling and before and after light curing to detect color matching. The 80 remaining teeth were restored with OM (n = 40) and FT (n = 40); half (n = 40) were submerged in coffee and the other half (n = 40) were submerged in cola for 2 weeks. The color stability was assessed by calculating material color (spectrophotometry) changes (∆E) before and after staining in immersion medium. The means and standard deviations of the ∆E values relating to color matching and color stability (stain resistance) among the study groups were analyzed using ANOVA and Tukey’s post hoc test. FT showed significantly better color matching (lower ΔE) in comparison to OM-UC specimens for shades B1, B2, and A3 (p &lt; 0.01). Regarding the color stability in cola, the FT samples showed significantly lower ΔE values (indicating better color stability) compared to OM samples for all four shades (p &lt; 0.01). The ΔE values of OM and FT samples in coffee were comparable (p &gt; 0.01), showing comparable color stability. The color matching ability of the single-shade resin composite (OM) was influenced by the tooth color. The conventional resin composite showed better color matching than the single-shade composite (OM). The color stability of the single-shade resin composite (OM) was dependent on the staining medium. The OM composite showed more compromised color stability than the conventional resin composite in cola and comparable color stability to conventional resin composite in coffee

Strong Association of Angiotensin Converting Enzyme-2 Gene Insertion/Deletion Polymorphism with Susceptibility to SARS-CoV-2, Hypertension, Coronary Artery Disease and COVID-19 Disease Mortality

Background: The ongoing outbreak of SARS-CoV-2 represents a significant challenge to international health. Several reports have highlighted the importance of ACE2 on the pathogenesis of COVID-19. The spike protein of SARS-CoV-2 efficiently binds to the angiotensin-converting enzyme 2 (ACE2) receptors and facilitates virus entry into the host cell. In the present study, we hypothesize that a functional insertion/deletion polymorphism-rs4646994 I/D and rs4240157 T &gt; C in the ACE gene could be associated with SARS-CoV-2 infection and mortality. Methodology: This study included 117 consecutive COVID-19 patients and 150 age matched healthy controls (ACE2-rs4646994 I/D) and 100 age matched healthy controls with ACE2 rs4240157 T &gt; C. We used Mutation specific PCR (MSP) for ACE2-rs4646994 I/D genotyping and amplification refractory mutation system (ARMS-PCR) for ACE2 rs4240157 T &gt; C genotyping. Results: Results indicated that there were significant differences in the genotype distributions of ACE2-rs4646994 I/D polymorphisms (p &lt; 0.030) and ACE2 rs4240157 T &gt; C between COVID-19 patients and controls (p-values &lt; 0.05). Higher frequency of DD genotype (48.71%) and D allele (0.67) was reported in COVID-19 patients than controls. Our results showed that the ACE2-DD genotype was strongly associated with increased COVID-19 severity (OR 2.37 (95%) CI = (1.19–4.70), RR = 1.39 (1.09–1.77), p &lt; 0.013) and also a strong association was seen with ACE2-ID genotype with COVID-19 severity (OR 2.20 (95%) CI = (1.08–4.46), p &lt; 0.020) in the codominant model. In allelic comparison, the D allele was strongly associated with COVID-19 severity (OR 1.58 (95% CI) (1.11–2.27), RR 1.21 (1.05–1.41) p &lt; 0.010). A significant correlation of ACE2-I/D genotypes was reported with Age (p &lt; 0.035), T2D (p &lt; 0.0013), hypertension (p &lt; 0.0031) and coronary artery disease (p &lt; 0.0001). Our results indicated ACE2-DD genotype was strongly associated with increased COVID-19 mortality (OR 8.25 (95%) CI = (2.40 to 28.34), p &lt; 0.008) and also ACE2-DD + DI genotype was strongly associated with increased COVID-19 mortality with OR 4.74 (95%) CI = (1.5214 to 14.7915), p &lt; 0.007. A significant correlation was reported between COVID-19 patients and age matched controls (p &lt; 0.0007). Higher frequency of heterozygosity TC (40%) followed by ACE2-CC genotype (24.78%) was reported among COVID-19 patients. Using multivariate analysis, ACE2–CT genotype was strong associated with SARS-CoV-2 severity with an OR 2.18 (95% CI) (1.92–3.99), p &lt; 0.010 and also ACE2–CC genotype was linked with COVID-19 severity with an OR 2.66 (95% CI) (1.53–4.62), p &lt; 0.005. A significant correlation of ACE2-T &gt; C genotypes was reported with gender (p &lt; 0.04), T2D (p &lt; 0.035). ACE2-CC genotype was strongly associated with increased COVID-19 mortality OR 3.66 (95%) CI = (1.34 to 9.97), p &lt; 0.011 and also ACE2-C allele was associated with COVID-19 mortality OR 2, 01 (1.1761–3.45), p &lt; 0.010. Conclusions: It is concluded that ACE-DD genotype and D allele was strongly associated with increased COVID-19 patient severity. In addition, ACE I/D polymorphism were strongly associated with advanced age, diabetes and ischemic heart disease in COVID-19 patients whereas ACE-II genotype was a protective factor against the development of severe COVID-19. ACE2-DD genotype was strongly associated with increased COVID-19 mortality. Additionally, ACE2–CC and CT genotypes were strongly associated with COVID-19 severity. Therefore, our study might be useful for identifying the susceptible population groups for targeted interventions and for making relevant public health policy decisions

Identification of New Mycobacterium tuberculosis Proteasome Inhibitors Using a Knowledge-Based Computational Screening Approach

Mycobacterium tuberculosis (Mtb) is a deadly tuberculosis (TB)-causing pathogen. The proteasome is vital to the survival of Mtb and is therefore validated as a potential target for anti-TB therapy. Mtb resistance to existing antibacterial agents has enhanced drastically, becoming a worldwide health issue. Therefore, new potential therapeutic agents need to be developed that can overcome the complications of TB. With this purpose, in the present study, 224,205 natural compounds from the ZINC database have been screened against the catalytic site of Mtb proteasome by the computational approach. The best scoring hits, ZINC3875469, ZINC4076131, and ZINC1883067, demonstrated robust interaction with Mtb proteasome with binding energy values of −7.19, −7.95, and −7.21 kcal/mol for the monomer (K-chain) and −8.05, −9.10, and −7.07 kcal/mol for the dimer (both K and L chains) of the beta subunit, which is relatively higher than that of reference compound HT1171 (−5.83 kcal/mol (monomer) and −5.97 kcal/mol (dimer)). In-depth molecular docking of top-scoring compounds with Mtb proteasome reveals that amino acid residues Thr1, Arg19, Ser20, Thr21, Gln22, Gly23, Asn24, Lys33, Gly47, Asp124, Ala126, Trp129, and Ala180 are crucial in binding. Furthermore, a molecular dynamics study showed steady-state interaction of hit compounds with Mtb proteasome. Computational prediction of physicochemical property assessment showed that these hits are non-toxic and possess good drug-likeness properties. This study proposed that these compounds could be utilized as potential inhibitors of Mtb proteasome to combat TB infection. However, there is a need for further bench work experiments for their validation as inhibitors of Mtb proteasome

Argus II retinal prosthesis for retinitis pigmentosa in the Middle East: The 2015 Pan-American Association of Ophthalmology Gradle Lecture

Background: To describe the outcomes of patients with retinitis pigmentosa (RP) who received the Argus II Retinal Prosthesis System. Methods: This retrospective, interventional case series evaluated 10 consecutive patients who received the Argus II retinal implant and underwent visual function tests with the system on and system off. The main outcome measures were safety (the number, seriousness, and relatedness of adverse events), and visual function measured by computer-based objective tests, including square localization (SL) and direction of motion (DOM). Secondary measures included functional vision performance, including orientation and mobility (O&amp;M) tasks. Results: There were no intraoperative complications and all prostheses remained implanted at the end of follow up. The mean patient age was 41.3&nbsp;years; mean duration of the implant in vivo was 2.1&nbsp;years. One patient had a suture exposure over the coil suture tab and over the inferior case suture tab at 2&nbsp;years postoperatively, which was managed successfully. One patient developed mild vitreous hemorrhage that resolved spontaneously. One patient developed high intraocular pressure postoperatively due to a tight scleral band (SB) that was managed successfully. Patients performed significantly better with the Argus II system on than off on all tasks. Conclusion: Patients who received the Argus II had a safety profile out to 4&nbsp;years post-implantation that was markedly better than that observed in the pre-approval phase of the Argus II. In this population of RP patients, the Argus II retinal prosthesis provided useful visual function over several years that likely translates into improved quality of life. Trial Registration: clinicaltrials.gov identifier, NCT00407602

Expression and new exon mutations of the human Beta defensins and their association on colon cancer development.

The development of cancer involves genetic predisposition and a variety of environmental exposures. Genome-wide linkage analyses provide evidence for the significant linkage of many diseases to susceptibility loci on chromosome 8p23, the location of the human defensin gene cluster. Human β-defensins (hBDs) are important molecules of innate immunity. This study was designed to analyze the expression and genetic variations in hBDs (hBD-1, hBD-2, hBD-3 and hBD-4) and their putative association with colon cancer. hBD gene expression and relative protein expression were evaluated by Real-Time polymerase chain reaction (qPCR) and immunohistochemistry, respectively, from 40 normal patients and 40 age-matched patients with colon cancer in Saudi Arabia. In addition, hBD polymorphisms were genotyped by exon sequencing and by promoter methylation. hBD-1, hBD-2, hBD-3 and hBD-4 basal messenger RNA expression was significantly lower in tumor tissues compared with normal tissues. Several insertion mutations were detected in different exons of the analyzed hBDs. However, no methylation in any hBDs promoters was detected because of the limited number of CpG islands in these regions. We demonstrated for the first time a link between hBD expression and colon cancer. This suggests that there is a significant link between innate immunity deregulation through disruption of cationic peptides (hBDs) and the potential development of colon cancer