Objectives: To evaluate the tools used during online education and examination of undergraduate medical students from students and medical instructors' experience and means to improve students' and instructors' online education experience in future. Materials and Methods: Two surveys were deployed online through social media (WhatsApp, LinkedIn, and Twitter) to medical students and instructors from all medical colleges in Saudi Arabia. The surveys include demographic data, tools used in the education process during coronavirus disease 2019 (COVID-19) pandemic, tools used in students' examination, and both groups' opinions about these tools. Descriptive statistical analysis was used to analyze the items included in the survey. Responses were presented as frequencies and percentages. Results: Responses from medical colleges in Saudi Arabia were collected and analyzed with a response rate of 72.2%. Data from 518 students and medical instructors showed that online education transformation had a positive feedback from both students and instructors for theoretical sessions teaching with limitations in the practical and clinical sessions. Conclusion: Online education in medical schools is new in Saudi Arabia. This mandatory shift to online teaching made us aware of the importance of restructuring and implementing the medical curriculum to support virtual education, especially in practical and clinical sessions learning.

Objectives: Our objectives are to estimate the prevalence of self-esteem and imposter syndrome, to compare their prevalence between genders and different academic years, and to determine their associated factors among King Saud University (KSU) medical students. Methods: Our study is a quantitative analytical cross-sectional study. Data were collected on the KSU campus. Participants in this research are KSU medical students including males and females from 1^st to 5^th year, with a sample size of 502. A stratified random sampling design was used. Data were collected through a self-administered questionnaire that includes the Young imposter scale, Rosenberg self-esteem scale, and sociodemographic factors. Results: The prevalence of low self-esteem and positive imposter syndrome is 23.6% and 42.1% (n = 573), respectively. There is a positive correlation between low self-esteem and positive imposter syndrome. There is a significant association between self-esteem and gender, mother's education, and Grade Point Average (GPA). Imposter syndrome is significantly associated with gender. Conclusion: Low self-esteem and positive imposter syndrome are prevalent among medical students, especially in the first few years and particularly in female students. These issues affect the mental health of medical students and thus need to be addressed to possibly improve the educational system.

Background: Multiple guidelines have recommended performing surveillance colonoscopies after resection of colorectal cancer. However, there has been debate about the optimal frequency of endoscopic surveillance and its yield. Objective: The objective of this study was to explore the adherence and the yield of surveillance colonoscopy in our population. Design: This was a retrospective cohort study. Setting: This study was carried out in two tertiary care centers in Riyadh of all patients who were found to have colon cancer on colonoscopy. Patients and Methods: All patients who were found to have colon cancer on colonoscopy at one center from January 2016 to July 2019 and the second center from April 2012 to April 2019 were included in the study. The main outcome measures were as follows: rate of adherence to surveillance colonoscopies as well as the rate of synchronous and metachronous tumors identified. The sample size was not calculated. Results: A total of 280 patients were identified with a mean age of 64.5 years (standard deviation: 13.1), 61.4% were male, and the majority (72%) of the original cancers were left sided (rectum – 25.45%, rectosigmoid – 13.45%, sigmoid – 25.82%, and descending colon – 7.27%). Surveillance was performed in 55.7%, 17.9% did not attend their scheduled procedures, 2.1% refused, while there was no clear reason in 8.9%. Surveillance was not applicable to 15.3% of the study population. Over the course of three rounds of surveillance, the timing of the procedures was in line with recommendations in 66.8% in the first round while it was 20% in the second and third rounds. The procedures were normal in 69%, 71.9%, and 90% of the first, second, and third rounds, respectively. Metachronous adenocarcinoma was seen in 2.6% and synchronous adenocarcinoma in 0.6% during the first round. Adenocarcinoma was found in 5 out of 75 patients in the second round and 1 out of 10 in the third round. Conclusion: The attrition rate and deviation from timing suggested by guidelines are high. Furthermore, the yield of surveillance colonoscopies for important findings is clinically relevant. The limitations of this study were as follows: retrospective, probability of unmeasured confounders, as well possibility of attrition bias.

Objectives: The first outbreak of COVID-19 was recognized in early March in Gulf Cooperation Council (GCC) countries and then accelerated at an exponential rate within a short period. The present study objective is to evaluate the prevalence of COVID-19 in GCC countries. Methods: Six countries are Saudi Arabia, Qatar, Kuwait, Bahrain, the United Arab Emirates (UAE), and Oman included in the study. Six parameters of COVID-19 data were collected from various dashboards. Data analyses of all parameters were expressed in frequencies and percentages. Results: The highest number of cases was reported in Saudi Arabia (347,282) and least in Bahrain (81,466). The cases in Saudi Arabia, Qatar, and Bahrain have been reported a decrease, while the UAE and Oman reported an increase in the month of October. The recovery rates in Qatar (97.76%) and the UAE (97.19%) showed highest. Saudi Arabia and Oman showed the highest death rate (1.56% and 1.06%), while Qatar lowest death rate (0.18%). Critical cases are more in Saudi Arabia (0.22%). Oman showed the highest number of active cases (8.88%). The highest percentage of COVID-19 infection rates are in Bahrain (4.75%) and Qatar (4.72%). The UAE (132.77%) and Bahrain (101.24%) reported the highest COVID-19-tested percentage, while Oman (7.32%) had the least in their given population. Conclusions: The status of COVID-19 in the UAE and Oman showed a slight increase in the cases. The overall outcomes represent the status of COVID-19 in GCC countries reliably under control. The strategies used by these countries played an extremely important role in preventing higher death rate and spread of the virus.

Context: Driving distance to health-care facilities has been associated with suboptimal glycemic control in patients with diabetes. The data pertaining to the driving burden on patients with diabetes in Saudi Arabia is lacking. Aims: This study aims to assess the driving distance to healthcare facilities and the glycemic control of patients with insulin-treated diabetes mellitus (ITDM) in Saudi Arabia. Setting and Design: This study is part of the diabetes and driving study–a cross-sectional project conducted on individuals with ITDM in Saudi Arabia. Materials and Methods: Data collection was performed from August 2016 to February 2017 from the designated clinics every alternate day, for 4-h intervals. We included men aged more than 18 years, with at least 1 year of follow-up with the clinic, and using a car as the main mode of transportation. Results: A total of 429 individuals were included in the study, they were mostly from Riyadh (95.3%, n = 409) with an average age of 49.54 ± 15.20 years. The distance driven was on average 32.09 ± 115.23 km. The average duration of diabetes was 14.36 ± 8.44 years. Most (80.4%; n = 345) had uncontrolled diabetes and were almost equally distributed between those driving <10 km (55.48% n = 238) and more. We found statistically significant associations between driving for more than 10 km to access healthcare (odds ratio [OR] = 1.47; confidence interval [CI] 1.127–1.92); P = 0.004) and lower age (OR = 0.97; CI = 0.949, 1.00; P = 0.029) with uncontrolled diabetes. Conclusion: Patients with ITDM in Saudi Arabia have a driving burden if the healthcare facilities located far, which also might be associated with poor glycemic control. A thorough study of healthcare facilities and location of diabetes centers needs to be implemented on a national level.

Background: The diagnosis and treatment of breast cancer often result in significant psychological distress. However, the manner in which distress differentially affects patients with various forms of disease is less well researched. This study sought to examine the differences in the psychological experiences of patients diagnosed with breast cancer and those diagnosed with cancer in other sites with particular focus on stress, anxiety, hopelessness, and suicidal ideation (SI). Materials and Methods: Convenience sampling was used to select participants comprising female patients with breast cancer (n = 80) and female patients with other forms of disease (n = 80) in Durban, South Africa. The participants were all receiving adjuvant chemotherapy and/or radiotherapy. These participants were asked to complete a questionnaire battery consisting of, inter alia, the Beck Depression Inventory, the Rosenberg Self-Esteem Scale, and the Stress Symptom Checklist. Results: The results suggest that although the levels of depression between the two groups did not show any significant differences, breast cancer patients experienced notably higher levels of hopelessness and SI. Moreover, they expressed their stress through different responses, both in psychological and behavioral terms, which resemble the symptomatology present in anxiety. Conclusions: Breast cancer patients experience higher levels of hopelessness and SI as compared to patients with other forms of disease and express their stress by differing means. This study highlights for those professionals in health care, specifically those involved in oncology, the prevalence and the characteristics of this distress and the importance of identifying at-risk patients to further refer them for supportive therapy.

Purpose: In response to ongoing coronavirus disease (COVID)-19 pandemic, flu clinics were set by most of the hospitals all over India to screen patients for the disease. The study aimed to find out treatment outcome of patients attending a flu clinic at a tertiary health-care facility. Methods: It is an observational study, cross-sectional in design. The study used data routinely collected at the flu clinic of a selected tertiary health-care facility of a selected state of India. Data collected between March 22, 2020, and May 31, 2020 were used for the study. Results: Among 3873 study participants, 364 (9.4%) required admission in COVID-19 isolation ward for testing, while 1536 (39.6%) were referred for further management and the rest being symptomatically managed or home quarantined. In multivariate multinomial logistic regression analysis, females, lockdown phases, symptomatic, severe acute respiratory illness patients, those with contact history with a COVID-19 case, chronic comorbidities, and health worker had significantly higher odds of being admitted in COVID-19 isolation ward compared to others. Those who belonged to the age group of 16–30 years had significantly lower odds of admission. On the other hand, age, sex, lockdown phases, native district COVID-19 risk category, symptom status, chronic comorbidity, contact history, travel history. and profession were significant predictors of referral for further management. Conclusion: Half of the study participants were home quarantined or symptomatically managed. Age, sex, symptom status, contact history, travel history, chronic comorbidity, and profession were significant predictors for their treatment outcome.

Background: Research in academia suggests that types of school may have an impact on learning styles. The study is aimed to examine the learning styles of students from medical institutions using different types of curriculum. Methods: This descriptive cross-sectional study was conducted in the three largest public-sector medical colleges using conventional, hybrid, and a problem-based learning-based curriculum in Saudi Arabia. By using convenient sampling, we collected 316 responses. The questionnaire consisted of sociodemographic data and index of learning style instrument. The categorical data were presented as percentages and descriptive data were analyzed using the Chi-square test. Value of P < 0.05 level was considered statistically significant. Results: Of the 316 participants, the male-to-female ratio was 1:1. Gender was associated with a significant difference in the visual/verbal dimension (P = 0.034). Irrespective of college, most of the participants are primarily balanced in active/reflective (67.2%), visual (51.1%), and sequential (68.8%) with slight shift toward sensing (47.6%). Significant differences between colleges were found in sensing/intuitive (P = 0.005) and sequential/global (P = 0.012) dimensions. There was no significant association between academic years with learning styles in the three medical colleges from public sector universities. Conclusion: Irrespective of college, most of the participants' preferred style was visual illustrations supported by hands-on teaching in a stepwise process. Although, medical students in different universities possessed different learning styles. It has also been shown that students in a single university tend to develop the same learning styles as they advance through the years. The collaboration between institutions using different types of the curriculum may increase the quality of education by developing effective teaching and learning methods that correspond with the learning styles of students.

Background: Nutrition in elderly patients has been the topic of interest in field of geriatrics. Quality of life is directly correlated with nutritional status in geriatric patients. Aim of the Study: This study was undertaken to evaluate the nutritional status when completely edentulous patients were rehabilitated with conventional complete dentures. Materials and Methods: Hundred edentulous patients, in the age group of 45–65 years, were selected, and biochemical blood analysis was done at three different time periods (0, 3, and 6 months after delivery of complete dentures) for levels of calcium, protein, phosphorus, and hemoglobin in blood. The results at three different time periods were then compared to evaluate the change in the values of these nutrients in the body. Results: Loss of teeth was associated with lower than normal values for calcium, protein, phosphorus, and hemoglobin in blood. There was a significant improvement in the blood calcium and protein levels at the end of 3 months, whereas there was no significant improvement in the blood phosphorus and hemoglobin. Conclusion: Complete denture rehabilitation has a definite positive impact on nutritional status of geriatric patients.

Introduction: There have been numerous studies on hydatidiform mole (HM) in Nigeria, but some lacked histological diagnosis, and others did not differentiate complete hydatidiform mole (CHM) from partial hydatidiform mole (PHM). In addition, none of these studies involved immunohistochemical (IHC) diagnosis or assessed the accuracy of morphologic diagnosis of CHM. The objective of this study is to determine the epidemiology and accuracy of morphologic diagnosis of CHM using p57^KIP2 IHC stain. Materials and Methods: The paraffin blocks of histologically diagnosed cases of CHM and PHM seen at two histopathology laboratories in Nnewi, South-East Nigeria, were retrieved from the archives. IHC staining for p57^KIP2 was done. Results: In this study, we reviewed and reclassified 54 cases of routinely stained HMs as 15 (27.8%) CHMs and 39 (72.2%) PHMs. However, following IHC staining, we further reclassified them as 21 (38.9%) CHMs and 33 (61.1%) PHMs. Discordant histopathological diagnosis between routine staining with hematoxylin and eosin (H and E) and IHC staining with p57^KIP2 was identified in eight cases (which constitutes 14.8% of the studied cases): one case was a false-positive diagnosis, while the remaining seven cases were false-negative diagnosis. Thus, the sensitivity and specificity of histopathological diagnosed cases of CHM by H and E were 66.7% and 97%, respectively, with a positive predictive value of 93.3%, negative predictive value of 82.1%, and total accuracy of 85.2%. Conclusions: Morphology alone is suboptimal for accurate diagnosis of CHM. We therefore strongly recommend the routine use of p57^KIP2 immunostain in all suspected cases of HM.

Background: During the coronavirus disease-2019 pandemic, learning activity via the digital medium has suddenly increased. Medical teachers quickly adapted with synchronous (i.e., online classes), and asynchronous (i.e., video-and other materials-based learning) method of delivering the content to the students. Aim: We aimed to explore the comparative preference of face-to-face lecture, synchronous, and asynchronous learning among Indian undergraduate medical students. Materials and Methods: We conducted a cross-sectional nation-wide online survey in July–August 2020 with a snowball sampling technique. We collected response from undergraduate medical students who had attended both online classes and video-and other materials-based learning. Preference on the three modes of learning (namely, face-to-face lecture, online synchronous, and asynchronous) was recorded in a 10 point Likert-type scale. Obtained responses were statistically compared by analysis of variance with a P < 0.05 to be statistically significant. Results: A total of 695 (female = 304 (43.74%), male = 391 (56.26%)) entries were analyzed. Overall, traditional face-to-face lecture class was the most preferred method (8.68 ± 1.49) followed by asynchronous (6.33 ± 2.22) learning and then online classes (5.22 ± 2.55, P < 0.0001). Perceived attention, interest, scope of learning, and possibility of interaction with the teachers were highest in face-to-face lecture. The scope of taking notes from all three modes was equal but the scope of formative assessment was highest with synchronous learning. The distraction was highest with asynchronous learning. Conclusion: Undergraduate medical students in India prefer to learn by face-to-face lecture while compared with distance delivery via the digital media. Postpandemic blended learning may be planned with the following sequence of importance: Face-to-face lecture >asynchronous >synchronous learning.

Aim: The aim of this study was to determine the prevalence of low back pain (LBP) and to identify risk factors associated with LBP among medical students. Materials and Methods: A cross-sectional study was conducted among 2021 medical students from four medical colleges in Saudi Arabia during the academic year 2019–2020. A self-administered questionnaire was conducted and included three sections: demographic data, risk factors of LBP, and prevalence of LBP (during lifetime, past 12 months, and past 7 days). Data were analyzed using SPSS. Results: A total of 2021 medical students responded to our survey. The participants were 57.1% female and 42.9% male. Most of the students' ages (76.3%) ranged from 20 to 24 years. Medical students younger than 20 and older than 24 were 21.8% and 1.9%, respectively. The prevalence of LBP was 80.7% at any time, 67.6% in the past 12 months, and 38.2% in the past 7 days. Females were found to have higher prevalence of LBP than males (P < 0.0001), 95% confidence interval (CI) (1.37, 2.04). History of physical trauma to the back was significantly associated with LBP (P < 0.0001), 95% CI (1.32, 2.40). A lack of daily exercise was also found to be associated with LBP (P = 0.015), 95% CI (1.05, 1.55). LBP affected the daily functions, such as walking and sleeping, of 30.1% of medical students. Around 11% of medical students sought medical care because of LBP. Conclusions: We conclude that the prevalence of LBP is high among Saudi medical students. LBP seemed to be higher in females and associated with history of back trauma. Back care awareness should be emphasized among medical students.

Polycystic ovarian syndrome (PCOS) is an important public health problem. In addition to its gynecologic and hyperandrogenic manifestations, it has been associated with an increased incidence of prediabetic state, gestational diabetes mellitus (GDM), and diabetes mellitus. The pathogenesis of PCOS, as well as its metabolic consequences, is complex. The two main causative factors are intrinsic insulin resistance and impaired β cell function. Obesity has frequently been reported in PCOS; however, it is not entirely responsible for the insulin resistance in this population. PCOS should be managed with lifestyle modifications and appropriate dietary measures. In addition, treatment with insulin sensitizers is usually needed. PCOS provides a unique opportunity for the screening and early diagnosis of diabetes and its management.

Massive open online courses (MOOCs) commonly refer to a group of courses that are offered on a wide range of interesting topics on the online platform and are generally open for all. An extensive search of materials related to the topic was carried out in the PubMed search engine and relevant research articles published in the period 2016–2019 were included in the review. Amid the ongoing coronavirus disease-2019 pandemic, an exponential rise in the demand for online courses has been reported owing to the reduction in the possibility of conventional face-to-face teaching. These courses help the medical students to become self-directed and lifelong learners and eventually play a significant role in meeting the vision of a competent Indian Medical Graduate. In fact, the Medical Council of India recognized the utility of such courses and has made it mandatory for all the postgraduates and even for teaching staff to enroll in the basic course in Biomedical research as a part of enhancing their exposure to research. In conclusion, the enrollment of medical students in MOOC courses can prove to be extremely useful for them in refining their professional skills. However, it is essential to guide the students to opt for the right course out of the available wide range of courses, so that they take a well-informed decision and get benefited from job perspective as well.

The successful practice of medicine requires an effective team work, and in order to be a leader and a contributor to the team, a medical undergraduate student should acquire these traits during their training period. This highlights the need for a medical student and students from other allied health sciences to work and learn in an interprofessional team during their undergraduation period and as a part of the continuing professional development. An extensive search of all materials related to the topic was carried out in the PubMed search engine, and relevant research articles published in the period 2009–2020 were included in the review. Interprofessional education and learning have gained considerable importance as it can be looked upon as a strategy to optimize the use of educational resources, reduce the workload of training, and eventually deliver a cost-effective, efficient, and holistic package of services to the beneficiaries. However, in order to ensure smooth execution of interprofessional learning, there is an immense need to perform a thorough curriculum planning and offer support to the staff. In conclusion, the approach to adopt interprofessional education in medical education will play a significant role in improving the competence and capacity of the medical students to be ready for the dynamic challenges of the health-care delivery.