The need for national medical licensing examination in Saudi Arabia

<p>Abstract</p> <p>Background</p> <p>Medical education in Saudi Arabia is facing multiple challenges, including the rapid increase in the number of medical schools over a short period of time, the influx of foreign medical graduates to work in Saudi Arabia, the award of scholarships to hundreds of students to study medicine in various countries, and the absence of published national guidelines for minimal acceptable competencies of a medical graduate.</p> <p>Discussion</p> <p>We are arguing for the need for a Saudi national medical licensing examination that consists of two parts: Part I (Written) which tests the basic science and clinical knowledge and Part II (Objective Structured Clinical Examination) which tests the clinical skills and attitudes. We propose this examination to be mandated as a licensure requirement for practicing medicine in Saudi Arabia.</p> <p>Conclusion</p> <p>The driving and hindering forces as well as the strengths and weaknesses of implementing the licensing examination are discussed in details in this debate.</p

Physiological basis and image processing in functional magnetic resonance imaging: Neuronal and motor activity in brain

Functional magnetic resonance imaging (fMRI) is recently developing as imaging modality used for mapping hemodynamics of neuronal and motor event related tissue blood oxygen level dependence (BOLD) in terms of brain activation. Image processing is performed by segmentation and registration methods. Segmentation algorithms provide brain surface-based analysis, automated anatomical labeling of cortical fields in magnetic resonance data sets based on oxygen metabolic state. Registration algorithms provide geometric features using two or more imaging modalities to assure clinically useful neuronal and motor information of brain activation. This review article summarizes the physiological basis of fMRI signal, its origin, contrast enhancement, physical factors, anatomical labeling by segmentation, registration approaches with examples of visual and motor activity in brain. Latest developments are reviewed for clinical applications of fMRI along with other different neurophysiological and imaging modalities

Identification andDifferentiation of Trichophyton Mentagrophytes and T.rubrum by Polymerase Chain Reaction and Enzymatic Digestion

Introduction & Objective: Trichophyton rubrum and T. mentagrophytes are most common causative agents of dermatophytosis in the world. Differentiation of these species is important from the epidemiological and pathological point of view. Conventional methods including macroscopic and microscopic morphology and biochemical tests are time-consuming (in some cases it takes 3-4 weeks), laborious and still sometimes insufficient to identify these agents. The aim of this study was to use polymerase chain reaction followed by enzymatic digestion for differentiation of these 2 species. Materials & Methods: In this descriptive–experimental study one hundred strains were isolated from patients with dermatophytosis. Preliminary identification was done by morphological methods. DNA was isolated and purified by glass-bead methods and ITS1- 5.8SrDNA-ITS2 region was amplified by PCR and the amplicon was digested by the restriction enzyme MvaI. The products were visualized after agarose gel electrophoresis and staining. Differentiation of the species was based on sequence analysis and the electrophoretic patterns. Results: Morphological tests were not able to definitely differentiate the two tested species, especially for isolates with intermediate features. Using molecular methods, it was found that 45 isolates are T. rubrum and 54 are T. mentagrophytes. One isolate was Fusarium spp. Physiological tests were confirmed the results except for 4 isolates. It was also found that hair perforation test is more reliable than urease test for differentiation of these two species. Conclusion: We found that DNA-based method, although expensive, is a fast and reliable method for differentiation of T. rubrum and T. mentagrophytes. The frequency of mentioned species was almost similar in the tested isolates. The method is recommended for differentiation of other dermatophytes

Fungal agents in different anatomical sites in Public Health Services in Cuiabá, state of Mato Grosso, Brazil

INTRODUCTION: A contribution to the regional epidemiological profile of the most common fungal agents in Public Health Services in Cuiabá, state of Mato Grosso, including university hospitals and polyclinics. METHODS: Clinical specimens (n = 1,496) from 1,078 patients were collected, submitted to direct mycological exam (potash or stick tape method) and cultured in specific mediums. Dermatophytic and non-dermatophytic agents were identified according to micromorphology (Ridell technique). RESULTS: The majority of the 1,496 specimens were skin (n = 985) and nail exams (n = 472). Of the 800 positive cultures, 246 (30.8%) corresponded to dermatophytes and 336 (42%) to yeasts of the genus Candida, 190 (23.7%) to other yeasts, 27 (3.4%) to non-dermatophytic filamentous fungi and one (0.1%) the agent of subcutaneous mycosis. Lesions considered primary occurred in greater numbers (59.5%) than recurrent lesions (37.4%), with a greater concentration of positivity occurring on the arms and legs. CONCLUSIONS: Comorbidities, allergies and diabetes mellitus were conditions associated with greater positivity in direct mycological exams and cultures. Positive culture was considered a definitive diagnosis of fungal infection and confirmed 47.8% of diagnostic hypotheses