Ghadeer Al-Shaikh

What determines the selection of undergraduate medical students to the specialty of their future careers

Background: It is important to understand the factors that influence the undergraduate medical students’ specialties choice for the post-graduation. Objectives: To identify the number of undergraduate medical students who decided their post-graduate specialty career, factors that may influence their decision to select a particular specialty, and their career specialties preference. Methods: A self-administered questionnaire was used to achieve the objectives. Results: Less than half of the students (40.2%) showed a future specialty preference. Senior students and having background about specialties were the significant factors for career choices. General Surgery (27.4%), ENT-Ophthalmology (24.6%) and Internal Medicine (22%) were preferred specialties. Male students preferred General Surgery (15.7%), Internal Medicine (15%), ENT-Ophthalmology (12%) and Orthopedics (9.1%). Female students showed interest in ENT-Ophthalmology (12.1%), Surgery (11.7%), Pediatrics (10.8%) and Dermatology (8.2%). The least popular specialties were Community Medicine, (6.6%), Anesthesia, (6%) and Forensic Medicine (4.6%). Obstetrics and Gynecology (Ob/Gyne) was a less popular branch even in female students. Conclusions: General Surgery, ENT-Ophthalmology and Internal Medicine were the most preferred specialties, while Community Medicine, Forensic and Ob/Gyne, even for female students were least selected specialties. Proper information and counseling should be offered to students about the challenges and opportunities to select their future careers.

Recurrent Urinary Tract Infections Management in Women: A review

Urinary tract infections (UTIs) are one of the most frequent clinical bacterial infections in women, accounting for nearly 25% of all infections. Around 50-60% of women will develop UTIs in their lifetimes. Escherichia coli is the organism that causes UTIs in most patients. Recurrent UTIs (RUTI) are mainly caused by reinfection by the same pathogen. Having frequent sexual intercourse is one of the greatest risk factors for RUTIs. In a subgroup of individuals with coexisting morbid conditions, complicated RUTIs can lead to upper tract infections or urosepsis. Although the initial treatment is antimicrobial therapy, use of different prophylactic regimens and alternative strategies are available to reduce exposure to antibiotics.

Riyadh Mother and Baby Multicenter Cohort Study: The Cohort Profile

Objectives To assess the effects of non-communicable diseases, such as diabetes, hypertension and obesity, on the mother and the infant. Methods A multicentre cohort study was conducted in three hospitals in the city of Riyadh in Saudi Arabia. All Saudi women and their babies who delivered in participating hospitals were eligible for recruitment. Data on socio-demographic characteristics in addition to the maternal and neonatal outcomes of pregnancy were collected. The cohort demographic profile was recorded and the prevalence of maternal conditions including gestational diabetes, pre-gestational diabetes, hypertensive disorders in pregnancy and obesity were estimated. Findings The total number of women who delivered in participating hospitals during the study period was 16,012 of which 14,568 women participated in the study. The mean age of the participants was 29 ± 5.9 years and over 40% were university graduates. Most of the participants were housewives, 70% were high or middle income and 22% were exposed to secondhand smoke. Of the total cohort, 24% were married to a first cousin. More than 68% of the participants were either overweight or obese. The preterm delivery rate was 9%, while 1.5% of the deliveries were postdate. The stillbirth rate was 13/1000 live birth. The prevalence of gestational diabetes was 24% and that of pre-gestational diabetes was 4.3%. The preeclampsia prevalence was 1.1%. The labour induction rate was 15.5% and the cesarean section rate was 25%. Conclusion Pregnant women in Saudi Arabia have a unique demographic profile. The prevalence of obesity and diabetes in pregnancy are among the highest in the world.

Reliability of Arabic ICIQ-UI short form in Saudi Arabia

Context: The International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) provides a brief measure of symptoms and impact of urinary incontinence on quality of life. It is suitable for use in clinical practice and research. An Arabic version of the ICIQ-UI SF was translated and validated in Egypt and Syria. Aims: The objective was to assess the reliability of the Arabic version of the ICIQ-UI SF in women from Saudi Arabia. Settings and Design: A study at the Urogynecology Clinic was conducted from November 2010 until August 2011. Materials and Methods: Thirty-seven consecutive Saudi women attending urogynecologic clinic were recruited. Questionnaires were distributed for self-completion and then redistributed to the same set of respondents two to four weeks later as part of a test-retest analysis for assessing questionnaires stability. Statistical Analysis Used: Agreement between two measurements was determined by weighted Kappa. Internal consistency was assessed using Cronbachs alpha coefficient. Results: Participants had a mean (SD) age of 39 (9.9), median parity of 4, and mean BMI (SD) of 30.9 kg/m2 (4.6). There were no differences in the frequency and amount of urine leaks or the impact of UI on quality of life observed between the two visits. Assessment of internal consistency was excellent with the Cronbachs alpha coefficient of 0.97 (95% CI: 0.88-0.98). Participants agreed that the questionnaire was clear, appropriate, and easy to understand. Conclusions: The Arabic ICIQ-UI SF is a stable and clear questionnaire that can be used for UI assessment in clinical practice and research among Saudi women.

Effectiveness and outcomes of thermablate endometrial ablation system in women with heavy menstrual bleeding

Abstract Heavy menstrual bleeding (HMB) is a common problem in women of reproductive age group with major impact on their quality of life (QoL). The aim was to study the short-term effectiveness of Thermablate Endometrial Ablation System (EAS) and its impact on QoL in women with HMB. This was a prospective cohort study conducted on consecutive 72 women suffering from HMB. The success rate was estimated and patients’ QoL was compared before and after the procedure using the Aberdeen menorrhagia severity scale. The mean follow-up period was 18 months (6–24 months). The mean age and body mass index were 48 (±5.2) years 33.2 (±7.4) kg/m2 respectively. Among treated participants, 58 (80.6%) reported the absence of bleeding. A significant decrease was observed in the rate of missed social activity and increase in the leisure time activities. The overall patient satisfaction was 95.7%. Thermablate EAS is an effective minimally invasive treatment with marked improvement in QoL in women with HMB. Impact statement Heavy menstrual bleeding (HMB) is a common problem that affects 11–13% of reproductive age women with major impact on their quality of life (QoL). A variety of methods for endometrial ablation has been used for the destruction of the endometrial lining to treat HMB. The short-term results of this study shows amenorrhoea rate of (80.6%) after the procedure and a significant decrease in the rate of missed social activity and increase in the leisure time activities with marked improvement in QoL. The overall patient satisfaction was 95.7%. Thermablate Endometrial Ablation System is an effective minimally invasive treatment for HMB with advantages of shorter operating time, shorter hospital stay and high-level patient satisfaction. However, further clinical research with large-scale studies and possible comparison with other treatment options are recommended.

Pessary use in stress urinary incontinence: a review of advantages, complications, patient satisfaction, and quality of life

Stress urinary incontinnce (SUI) is a common condition among women. The usual approach to treatment of SUI is a stepwise plan from conservative to surgical procedures. A vaginal pessary is one of the commonly used conservative treatments that offer symptomatic improvement for women with incontinence. This review provides a critical analysis of the benefits and shortcomings offered by vaginal pessaries to patients affected by SUI, with a particular focus on indications, advantages, quality of life, patient satisfaction, and potential complications. To obtain the required information, an extensive search of PubMed and Cochrane databases was performed, covering the time frame from January 2000 to December 2016. We also surveyed the published guidelines of American Urological Association, Canadian Urological Association, American Urogynecological Society, National Institutes of Health (USA), and National Institute for Health and Care Excellence (UK). A total of 192 original research papers, review articles, and clinical trials were identified. The analysis of retrieved data provides evidence that vaginal pessaries constitute an effective nonsurgical option for SUI. The satisfaction rate with pessary use is high and only minor complications, if any, occur, vaginal discharge being the most common. The reviewed studies document that vaginal pessaries provide an adequate control of SUI if they are fit properly and managed by frequent replacements and regular checkups. They should be considered among the first line of treatment for SUI associated with exercise and increased intra-abdominal pressure.

Interprofessional learning experiences: Exploring the perception and attitudes of Saudi Arabian medical and dental students

Abstract Objective: The objective of this study is to evaluate the awareness and attitudes of medical and dental students regarding interprofessional learning (IPL). Methods: A cross-sectional study was conducted with 278 female undergraduate Medical and Dental students from Princess Nourah bint Abdulrahman University, Riyadh. These students undertook IPL in the Foundation block, in basic science teaching, clinical skills’ laboratories and in professionalism and learning skills’ modules. A modified, validated RIPLS questionnaire with four subscales and 29 items was used to collect data regarding their perception and attitudes towards shared learning. A five-point Likert scale was used with a value ranging from 1 (strongly disagree) to 5 (strongly agree) for each item. Factor analysis was done using Varimox rotation. Student’s t test was applied to detect difference between mean scores of medical and dental student’s responses Results: The mean age of respondents was 19.8 ± 1.7 years with the majority in the second year of each program. There was no difference in mean responses of the medical and dental students. The respondents favored shared learning in the areas of professional skills and patient care. They agreed that IPL helps to develop respect, trust and appreciation for other professions; however, both groups preferred to learn uni-professionally with regard to developing discrete professional identities and roles. Conclusions: There is an overall positive response towards IPL and the value of team work; however, more attention needs to be paid to enabling students to learn about the specific roles of each profession in the healthcare team.

Incidence of Early Postpartum Voiding Dysfunction in Primiparae: Comparison Between Vaginal Delivery and Cesarean Section

To compare the incidence of early postpartum voiding dysfunction (PPVD) in primiparae women delivered vaginally (VD) to those delivered by elective Caesarean section (CS).

A cervix penetrating the posterior bladder wall: case report

Clinical manifestations of vesicouterine fistulas, a rare complication of cesarean section, include amenorrhea and cyclic hematuria (menouria) without urinary incontinence, a triad collectively known as “Youssef’s syndrome.” Fistulas affecting the uterus usually reside above the isthmus or at the cervix and have a distinct morphology composed of granulation tissue, chronic inflammatory cells, and fibrous tissue. We present a case of Youssef’s syndrome where the patient’s entire cervix penetrated into the posterior bladder wall rather than the two organs connecting via a discrete fistulous tract.

Social Disapproval and Reasons Behind Tobacco Use as Perceived by Pregnant Women

Background : Societal perception of smokers, and reasons behind them smoking both reflect acceptance or rejection of smoking behaviour and can reframe tobacco prevention and/or cessation programs to be more effective in tobacco control. This study aimed at targeting the social unacceptability of smoking amongst Saudi females and considering their opinions of the reasons behind smoking amongst both genders. Methodology : We followed a cross-sectional approach towards data collection from a sample of pregnant women seen at the antenatal clinic at King Khalid University hospital, irrespective of their gestational age. The data was collected using a pretested, anonymous, self administered questionnaire. Results : 1208 pregnant women were included in our study. Their mean age was 29 + 6 years, and their mean gestational age was 29.6 + 7 weeks. Most women (88%) either agreed or strongly agreed that exposure to smoking may harm the foetus, and only 3.5% of them would accept to smoke if they were offered a cigarette by their husbands. The top reported reasons for smoking amongst males and females were: association with tobacco using friend, reduction of stress, and manifestation of masculinity or gender equality. Pregnant women were not impressed by smokers, and as less than 1% of them considered them attractive and about 25% of them believed male and female smokers feel insecure. Conclusion : The social disapproval of smoking behaviour in this study was prominent especially towards female smokers. Reasons behind smoking are still blamed on friends, family members and peer pressure. Such results are important in shaping tobacco prevention and control programs