Introducing inter-professional education in curricula of Saudi health science schools: An educational projection of Saudi Vision 2030

AbstractRecently, the Saudi government initiated plans to improve both the health care system and health profession education. Providing optimal care in health care institutions requires health care providers from different services to collaborate and interact. Evidence-based research has shown that optimizing the interactions and communication between health care workers improves patient outcomes and reduces medical errors. The use of interprofessional education (IPE) in undergraduate health profession programmes in some Western universities has been found to be an effective tool for improving communication and interaction between health care providers. This paper addresses the possibility of introducing IPE into health profession education in KSA to support Saudi Vision 2030

Autoimmune liver disease - are there spectra that we do not know?

Autoimmune liver diseases (AILDs) are common leading causes for liver cirrhosis and terminal stage of liver disease. They have variable prevalence among patients with liver disease and have two major clinical and biochemical presentations. Autoimmune hepatitis (AIH) is the typical example of hepatocellular AILD, but it can also be presented under a cholestatic pattern. AIH has a scoring diagnostic system and respond in most cases to the treatment with prednisolone and azathioprine. Primary biliary cirrhosis (PBC) is the second most common AILD, with a cholestatic presentation and characterized by positive antimitochondrial antibody (AMA). It has an excellent response and long term outcome with the administration of ursodeoxycholic acid (UDCA). Another AILD that is thought to be a variant of PBC is the autoimmune cholangitis, being a disease that has biochemical and histological features similar to PBC; but the AMA is negative. Primary sclerosing cholangitis (PSC) is a rare entity of AILD that has a cholestatic presentation and respond poorly to the treatment, with the ultimate progression to advance liver cirrhosis in most patients. Other forms of AILD include the overlap syndromes (OS), which are diseases with mixed immunological and histological patterns of two AILD; the most commonly recognized one is AIH-PBC overlap (AIH-PSC overlap is less common). The treatment of OS involves the trial of UDCA and different immunosuppressants. Here we present three case reports of unusual forms of chronic liver diseases that most likely represent AILD. The first two patients had a cholestatic picture, whereas the third one had a hepatocellular picture at presentation. We discussed their biochemical, immunological and histological features as well as their response to treatment and their outcomes. Then, we compared them with other forms of AILD

Autoimmune Hepatitis as a Unique Form of an Autoimmune Liver Disease: Immunological Aspects and Clinical Overview

Autoimmune hepatitis (AIH) is a unique form of immune-mediated disease that attacks the liver through a variety of immune mechanisms. The outcomes of AIH are either acute liver disease, which can be fatal, or, more commonly, chronic progressive liver disease, which can lead to decompensated liver cirrhosis if left untreated. AIH has characteristic immunological, and pathological, features that are important for the establishment of the diagnosis. More importantly, most patients with AIH have a favorable response to treatment with prednisolone and azathioprine, although some patients with refractory AIH or more aggressive disease require more potent immune-suppressant agents, such as cyclosporine or Mycophenolate Mofetil. In this paper, we discuss the immunological, pathological and clinical features of AIH, as well as the standard and alternative treatments for AIH

Liver diseases in pregnancy and outcomes: A retrospective study from Saudi Arabia

Liver diseases unique to pregnancy are common causes of both maternal and fetal mortality and morbidity. We retrospectively studied liver diseases unique to pregnancy, including hyperemesis gravidarum (HG); intrahepatic cholestasis of pregnancy; eclampsia; preeclampsia; hemolysis, elevated liver enzymes, and a low platelets (HELLP) syndrome; and acute fatty liver of pregnancy. We collected data including maternal age, gestational weeks at presentation and at delivery, mode of delivery, number of parity, and laboratory markers at 0, 1 week, and within 24 hours after delivery; from 112 patients (mean age, 29.8 years) from April 2015 - March 2017. SPSS 22 was used for statistical analysis. We The commonest liver disease in pregnancy was pre-eclampsia followed by HG. HG patients were younger compared with those with eclampsia and preeclampsia (P=0.025). Gestational week at presentation and the week of delivery were significantly greater for preeclampsia/eclampsia and HELLP patients compared to HG. Primigravida represented 42.9% of our patients. Fetal complications were reported in 29 (26%) of cases. Of those, 17 had fetal or neonatal death. Fourteen mothers (12.5%) had ICU admission. Pregnancy related liver diseases are important causes for fetal mortality and morbidity. Maternal age and gestational weeks are important predictors of fetal and maternal outcomes.   Les maladies du foie propres à la grossesse sont des causes courantes de mortalité et de morbidité maternelles et foetales. Nous avons étudié rétrospectivement les maladies du foie propres à la grossesse, y compris l'hyperemesis gravidarum (HG); cholestase intrahépatique de la grossesse; éclampsie; prééclampsie; hémolyse, élévation des enzymes hépatiques et syndrome de bas taux de plaquettes (HELLP); et stéatose hépatique aiguë de la grossesse. Nous avons recueilli des données comprenant l'âge maternel, les semaines de gestation à la présentation et à l'accouchement, le mode d'accouchement, le nombre de parité et les marqueurs de laboratoire à 0, 1 semaine et dans les 24 heures suivant l'accouchement; de 112 patients (âge moyen, 29,8 ans) d'avril 2015 à mars 2017. SPSS 22 a été utilisé pour l'analyse statistique. Nous La maladie hépatique la plus courante pendant la grossesse était la pré-éclampsie suivie de l'HG. Les patients atteints de HG étaient plus jeunes que ceux atteints d'éclampsie et de prééclampsie (P = 0,025). La semaine gestationnelle lors de la présentation et la semaine de l'accouchement étaient significativement plus importantes pour les patients prééclampsie / éclampsie et HELLP par rapport à HG. Primigravida représentait 42,9% de nos patients. Des complications foetales ont été rapportées dans 29 (26%) des cas. Parmi ceux-ci, 17 ont eu un décès foetal ou néonatal. Quatorze mères (12,5%) ont été admises à l'USI. Les maladies hépatiques liées à la grossesse sont des causes importantes de mortalité et de morbidité foetales. L'âge maternel et les semaines de gestation sont des prédicteurs importants des issues foetales et maternelles. &nbsp

Introducing inter-professional education in curricula of Saudi health science schools: An educational projection of Saudi Vision 2030

بدأت الحكومة السعودية مؤخرا، في وضع خطط لتحسين كل من نظام الرعاية الصحية والتعليم الصحي. ويتطلب توفير الرعاية المُثلى في مؤسسات الرعاية الصحية تعاون وتفاعل مقدمي الرعاية الصحية من القطاعات المختلفة. وقد بيّنت الأبحاث المبنية على البراهين أن تحسين التفاعل والتواصل بين العاملين في الرعاية الصحية يؤدي إلى تحسين نتائج علاج المرضى والتقليل من الأخطاء الطبية. وقد تبين أن استخدام التعليم المتداخل بين التخصصات في برامج تدريس التخصصات الصحية في بعض الجامعات الغربية أداة فعالة لتحقيق تواصل وتفاعل أفضل بين مقدمي الرعاية الصحية. تتناول هذه الورقة إمكانية إدخال التعليم المتداخل بين التخصصات في تعليم التخصصات الصحية في المملكة العربية السعودية لدعم رؤية السعودية ٢٠٣٠

Mentoring Clinical-Year Medical Students: Factors Contributing to Effective Mentoring

Theory: Academic mentoring is an effective method of enhancing undergraduate medical student academic performance, research productivity, career planning, and overall satisfaction. Hypotheses: This study investigates the relationship between mentor characteristics and mentee academic performance, with an emphasis on identifying students who need special support. Methods: A cross-sectional study was conducted among fourth-year medical students at King Abdulaziz University Faculty of Medicine undertaking the clinical skills module (CSM) rotation. Mentors included senior and junior faculty members from the Department of Internal Medicine and the Department of Family Medicine. King Abdulaziz University Faculty of Medicine assigned 1 mentor for every 10 medical students. We organized our mentoring program in the following format: (1) an initial group meeting (mentor with all 10 medical students) and (2) subsequent one-on-one meetings (mentor with each mentee alone). We assessed mentor characteristics, student academic performance and satisfaction, and the rate of mentees referred for special support. Results: A total of 184 students completed the CSM rotation. Among these, 90 students responded to the preprogram survey, with 83% reporting that mentoring was important to them. Group meetings and one-on-one meetings were attended by 60% and 49% of all students, respectively. The most frequent type of support required by the participating students was psychological support (12% of mentees). Participation in the mentoring program had no significant effect on student academic performance. Mentor seniority ( P  = .024) and motivation ( P  = .002) were significantly associated with the rate of student referral for special support. Conclusions: This study demonstrated that academic mentoring can be effective in enhancing student outcomes and promoting special support for students. Moreover, mentor and mentee motivation were found to be essential elements of a successful mentoring program