This article discusses the observational analytic study designs, i.e., case–control and cohort studies. These two study designs are useful for testing a hypothesis to determine the association between a risk factor and a disease. The analysis for both the studies is based on the conventional 2 × 2 table with the disease status in columns and the risk factor status in rows. The case–control studies start from the disease status and compare the exposure to the risk factor(s) between the diseased (cases) and the not diseased (controls) groups. The odds ratio is determined to compare the proportion of exposed persons in the two groups. The cohort studies start from the exposure to the risk factor status and compare the incidence of the disease in the exposed and not exposed groups. The relative risk compares the incidence between the two groups. The 95% confidence interval is estimated for both studies to determine an actual association between the risk factor and the disease. The strengths and limitations of the two study designs differ based on the direction of the two designs. The case–control study goes backward from the disease status so is more useful for rare diseases and for evaluating multiple risk factors, but it cannot determine causality, and there are chances of recall bias affecting the results of the study. The cohort studies are generally prospective in design from the exposure status and can determine the causal association between the risk factor and the disease. However, the cohort studies are more expensive and require a longer time as well as a larger sample size; the loss to follow-up and misclassification biases can affect the results of the cohort studies.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Objective: Our objective was to investigate the possible relationship between previous or concurrent use of losartan or valsartan and gout in newly diagnosed patients. Materials and Methods: Thirty-two newly-diagnosed gout patients, whose blood pressure was controlled using losartan for at least 3 months were included. The study was divided into 3 stages; stage I where patients were controlled for 3 months using losartan (50 mg/day), stage II - where patients were switched from losartan to valsartan (80 mg/day) with their blood pressure controlled and maintained for another 3 months using valsartan instead of losartan and stage III - where patients were switched back to losartan (50 mg/day). All changes in clinical and biochemical parameters were reported. Results: There were no significant changes in biochemical parameters such as liver enzymes, serum levels of creatinine, sodium and bicarbonate. Serum levels of potassium and uric acid were elevated. Valsartan significantly increased potassium and uric acid levels at the end of stage II (P = 0.024). Since these adverse effects did not disappear after changing back to losartan at the end of stage III, we performed an additional 3-month follow-up stage. The subjects required a period of 6 months to return to levels seen at the end of stage I. Conclusion: Losartan showed a slightly higher hypotensive effect than valsartan in patients newly diagnosed with gout. It also resulted in lower uric acid levels.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Pruritus or itch is an uncommon symptom observed in palliative care, even more uncommon in cancer patients. However, if a patient experiences pruritus, the 'itch-scratch' cycle can damage the skin integrity and can increase the susceptibility of patients to infection owing to their frail immune system. The outcome can be very distressing, dramatically impacting the quality-of-life of the patient. Moreover, since severe pruritus seen in patients with advanced disease can be associated with failure of different organ systems, pruritus must be assessed based on the underlying organ systems and the pathophysiology involved. Regardless of the cause of pruritus, general skin care is important. Depending on the origin of pruritus, specific approach and medications must be considered. Caution must be taken during management of pruritus since most cancer patients take pain medications that interact with some antipruritic medications. In addition to the complex and unclear nature of cutaneous and central pathogenesis of pruritus, treatment of pruritus is challenging.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

[FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

According to the World Health Organization, papillary thyroid microcarcinoma (PTmC) is a papillary thyroid cancer (PTC) measuring 10 mm or less in size. There has been a recent worldwide increase in the incidence of thyroid cancer, largely attributed to an increase in the incidence of PTC and more precisely to an increase in the incidence of PTmC. The management of PTmC continues to be an area of controversy and has resulted in wide differences in recommended management, ranging from observation to an aggressive approach with total thyroidectomy, central lymph node dissection and radioiodine ablation therapy. The aim of this review is to present some of the recently published studies discussing the clinical aspects of this disease (PTmC).

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Graves' disease is a common condition and is known to have a wide range of effects on a variety of organs. Hepatic dysfunction ranging from mild to severe due to direct effect of high circulating thyroid hormones as well as a deleterious effect of antithyroid medications (methimazole and propylthiouracil) has been well - documented in literature. However, severe autoimmune hepatitis (AIH) associated with Graves' disease is rare and limited to few case reports only. A 38-year-old woman presented with abdominal pain and yellowish discolouration of conjunctivae. On investigation, she was found to have Graves' disease and AIH. The liver histopathology showed typical features of AIH. She responded excellently to glucocorticoid therapy with normalisation of thyroid function and liver histology. The case is discussed with relevant literature review.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: The advantages of involving students in scientific research have been well-documented. Many educational organisations and universities have placed emphasis on integrating scientific research into the undergraduate curriculum. Aims: The objective of this paper is to elaborate on the importance of integrating scientific research into the undergraduate curriculum and to propose a model on how to integrate it into the current curriculums. Methods: In this proposed model, students would be exposed to research in each academic year from the 1^st year up to the 5^th year. In the 1^st year, students would attend lectures introducing them to scientific research. In the 2^nd year, students would be distributed among the faculty members and would be exposed to a more detailed research science by having lectures that explain research problems, and the objectives of the study. In the 3^rd year, students would have detailed lectures about study designs and how to write one. In the 4^th year, students would have lectures about biostatistics, in addition to, lectures that explain how to write the 'Results' section of their study in a manuscript format; then they would be trained to conduct the study and collect pertaining data. In the 5^th year, students would have lectures on the components of the 'Discussion' and 'Conclusion' sections as well as how to write them appropriately in a manuscript format. Finally, they would be taught on how to finalize editing of their research manuscript in preparation for publication. In the internship programme, they would be obligated to conduct another study independently, in order to evaluate their understanding. Conclusion: The undergraduate research is a cumulative learning experience which requires the support of the institute and faculty. Establishing a dental student research journal would encourage students to conduct and publish their research.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

The United Nations Millennium Development Goals (MDGs) project is coming to an end in 2015 and is being replaced by ambitious and aspirational Sustainable Development Goals (SDGs). Although the MDGs have been nearly achieved, this is not true in Sub-Saharan Africa where there is still unnecessarily high infant and childhood mortality and where there are many challenges to providing modern child health care. To achieve the SDGs in the next fifteen years, in low-income countries, national ministries of health and community health leaders will need to set reasonable goals and quality improvement projects. Attention needs to paid to economical, evidence-based effective health care; to education of children and youth and of health professional; health promotion and prevention of illness; a balance between expensive health care in large urban hospitals and community health projects; and most importantly to the social determinants of health. But the SDGs are achievable with coordinated and sustained national commitments and increased financial commitments from Western countries.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

In the last ten years our understanding of the origin of epithelial ovarian cancer has changed. This includes the realization that the majority of High Grade serous cancers originate in fallopian tube epithelium and the majority of endometroid and clear cell cancer arise in foci of endometriosis. These new insights have profound implications of both prevention and treatment.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Background: Being in the age of technological advancement, the human mind is under constant risk of being engulfed by social media leading to pathological internet use. Cyberworld serves as a buffer under stress by means of satisfying various needs of an individual in the form of entertainment, access to information, gaining recognition and maintaining relationships. Conversely, the morbid preoccupation of the internet was found to be averted by positive coping resilience and sense of self-efficacy under stressful condition. Objectives: To observe the pattern of internet use in medical students and to explore any possible relationship of internet use with stressful life event and resilience level. Materials and Methods: The study sample was drawn from medical undergraduates using semistructured questionnaire consisting of demographic profile, details of various aspects of internet use, internet addiction test questionnaire (IAT), resilience scale and student stress scale (SSS). Results: Almost all of the participants (n = 98) used the internet and social media. Mean age of the sample was 20.41 (±1.64) years, 64.3% were male and 35.7% female. On IAT, 80.6% students were moderate users, and 19.4% were problem users. IAT negatively correlated with resilience (r = −0.272, P = 0.007), whereas positively correlated with SSS total score (r = 0.330, P = 0.001) and total number of stressful life events (r = 0.335, P = 0.001). 30.6% of the students stated that a major life event had influenced their internet usage. In the linear regression model, life event appeared as a significant predictor of IAT score. Conclusion: Medical students acknowledge the role of the internet in surviving the enormous stress level brought on by various life events. At the same time, stressful life events could predict IA.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Introduction: Aspirin is widely used as either a primary or secondary preventive measure in of cardiovascular events however, platelets from diabetic patients are less responsive to aspirin and are unable to protect themselves from thrombotic events. Objective and Method: 180 diabetic patients were enrolled for measuring their platelet aggregation. The aim was to evaluate the prevalence of aspirin non-responsiveness among Saudi type II diabetic patients. Serum glucose level and other clinical data were collected to find out the possible determinant of reduced platelet sensitivity to aspirin. Results: The prevalence of aspirin non-responsiveness was 9.44%. A significant correlation between aspirin test and each of fasting blood sugar, HbA₁c, cholesterol and platelet count was observed. In contrast, there was no correlation among aspirin non-response, body mass index, age or hypertension. Conclusion: The relationship between the levels of glucose in the blood and aspirin resistance relates the importance of controlling blood glucose in diabetic patients to guarantee better aspirin action. Regular examining of type II diabetic patients to determine the sensitivity of platelet to the antiplatelet therapy is necessary to protect them from the risks of cardiovascular complications.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

[FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

[FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Objectives: To evaluate the King Saud University (KSU) medical students' perceptions of the educational programmes' quality. Materials and Methods: A total of 289 medical students at KSU, College of Medicine were selected randomly from year 1 through year 5 and were invited to participate in a descriptive cross-sectional study design. A questionnaire was distributed to the students and collected on completion. The questionnaire measured the students' perceptions of the educational programmes and their competence, as well as their overall satisfaction with the training delivered and the feedback system. Results: About 60.5% of the students declared that the educational programmes provided them with the necessary knowledge while only 48.5% of students believed that it provided them with the necessary skills required. Only 34% of students stated that the intended learning objectives were known to them at the beginning of the courses. About half of the students indicated that the programmes actively involved them in the problem-solving process. Half of the students believed that the amount of basic science knowledge provided was enough; however, 39.5% of students (in their clinical years) believed that the amount of knowledge delivered in the basic science courses was inadequate. Only 18.4% of students considered that the basic science courses prepared them for a clinical clerkship. 17.7% of the students declared that the research activities improved their research skills. 47.3% believed that the research activities helped them in understanding community characteristics, 57.6% asserted learning the basics of medical statistics, 44.6% believed it helped them in using the available resources in solving community problems and 49.5% believed it helped them in learning as well as acquiring project management skills. 34% of the students participated in planning educational activities while 53.7% participated in evaluating these educational activities. 36.1% of students gave frequent feedback to the college. Only 30.2% of the students were satisfied with the overall quality of the educational programmes. Conclusion: The students' perception of the educational programmes was illustrated and important aspects were highlighted which needed to be addressed and revised in order to improve the quality of the curriculum.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

[FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

[FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]