Awareness and Knowledge Among Medical Students Regarding Lower Gastrointestinal Bleeding Etiologies in Riyadh, Saudi Arabia

Background: Lower gastrointestinal bleeding is known as hemorrhage which originates from the lower gastrointestinal system. Undergraduate students must have adequate knowledge of this topic to help them in their practice and to be effectively engaged with their patient’s assessment and diagnosis. Objectives: This study aims to assess the awareness and knowledge among medical students about lower gastrointestinal bleeding etiology in the governmental universities of Riyadh, Saudi Arabia. Materials and methods: This cross-sectional study was conducted using a prepared electronic self-reported questionnaire among medical students at four different universities in the Riyadh region. After collecting the data, MS Word was used for data entry while SPSS version 23 was used for data analysis. Results: In this study, a total number of 1,129 responses were collected from students at four different universities. Most of the participants (61.6%) were between 21-23 years old. In general, it was shown that 58.2% of students have enough knowledge regarding the symptoms related to lower gastrointestinal bleeding. Moreover, the participant medical students have chosen the hemorrhoids (33.2%) to be the leading cause followed by diverticulosis (20.0%), and anal fissures (11.1%). Conclusion: It was found that among the more than 1000 medical students in Riyadh region, Saudi Arabia, the awareness level toward symptoms and causes of lower GI bleeding is inadequate. There is a need to improve the awareness of medical students regarding lower GI bleeding presentation, particularly those in pre-clinical years

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Postpartum xanthogranulomatous pyelonephritis: A case report

Xanthogranulomatous pyelonephritis (XGP) is seldom seen nowadays due to the aggressive treatment of upper urinary tract infections as well as recent advances in the management of urolithiasis. It has been rarely reported in the peri-partum period. We present a case of XGP without any evidence of renal calculi, manifesting in a 26-year-old previously healthy woman immediately post-partum. Keywords: Kidney, Mass, Renal cell carcinoma, Pyelonephritis, Xanthogranulomatous pyelonephriti

Outcomes of Human Papilloma Virus Vaccination in a Private Women Health Clinic in Lebanon

Objectives. The study aims to report on the feasibility and associated adverse events of HPV-Vaccination (HPVV) in a private clinic setting in Lebanon and, when available, the results of subsequent cervical cancer screening. Methods. Opportunistic HPV vaccination is offered at the Women’s Health Center of the AUBMC. We retrospectively reviewed the patients’ demographic data, the incidence of adverse events, and their cytological screening. Results. A cohort of healthy women (n = 1013) aged 26.2 years (12–54 years) were opportunistically vaccinated with one of two HPV vaccines; 845 (83.4%) received the quadrivalent vaccine (Q4V), and 151 (14.1%) received the bivalent vaccine (B2V). The majority (75.8%) received three doses while 16% received two doses. Out of these women, 26.3% (267) became sexually active postvaccination (NS2), whereas 17% (174) were sexually active prior to vaccination (SA) and the rest 57% (572) reported no sexual activity (NS1). Among the SA group, 26% (46/147) presented with abnormal cytology at time of vaccination. As for the NS2 women, 5% (14/267) had subsequently abnormal screening within 37 (12–103) months following vaccination. Conclusions. In this observational study, we report the successful introduction of HPVV with negligible adverse events. The incidence of abnormal cervical cytology was low among our patients

Role of the Retinoblastoma protein, Rb, during adult neurogenesis in the olfactory bulb

Adult neural stem cells (aNSCs) are relatively quiescent populations that give rise to distinct neuronal subtypes throughout life, yet, at a very low rate and restricted differentiation potential. Thus, identifying the molecular mechanisms that control their cellular expansion is critical for regeneration after brain injury. Loss of the Retinoblastoma protein, Rb, leads to several defects in cell cycle as well as neuronal differentiation and migration during brain development. Here, we investigated the role of Rb during adult neurogenesis in the olfactory bulb (OB) by inducing its temporal deletion in aNSCs and progenitors. Loss of Rb was associated with increased proliferation of adult progenitors in the subventricular zone (SVZ) and the rostral migratory stream (RMS) but did not alter self-renewal of aNSCs or neuroblasts subsequent migration and terminal differentiation. Hence, one month after their birth, Rb-null neuroblasts were able to differentiate into distinct subtypes of GABAergic OB interneurons but were gradually lost after 3 months. Similarly, Rb controlled aNSCs/progenitors proliferation in vitro without affecting their differentiation capacity. This enhanced SVZ/OB neurogenesis associated with loss of Rb was only transient and negatively affected by increased apoptosis indicating a critical requirement for Rb in the long-term survival of adult-born OB interneurons