Emerging infections including those resulting from the bioterrorist use of infectious agents have indicated the need for global health surveillance. This paper reviews multiple surveillance opportunities presented by mass gatherings (MGs) that align with fundamental questions in epidemiology (why, what, who, where, when and how). Some MGs bring together large, diverse population groups coming from countries with high prevalence of communicable diseases and disparate surveillance capacities. MGs have the potential to exacerbate the transmission dynamics of infectious diseases due to various factors including the high population density and rigor of events, increase in number of people with underlying diseases that predisposes them to disease acquisition, mixing of people from countries or regions with and without efficient disease control efforts, and varying endemicity or existence of communicable diseases in home countries. MGs also have the potential to increase the opportunities for mechanical and even heat-related injuries, morbidity or deaths from accidents, alcohol use, deliberate terrorist attacks with biological agents and/or with explosives and from exacerbation of pre-existing conditions. Responding to these wider range of events may require the use of novel bio-surveillance systems designed to collect data from different sources including electronic and non-electronic medical records from emergency departments and hospitalisations, laboratories, medical examiners, emergency call centres, veterinary, food processors, drinking water systems and even other non-traditional sources such as over-the-counter drug sales and crowd photographs. Well-structured, interoperable real-time surveillance and reporting systems should be integral to MG planning. The increase in magnitude of participants exceeding millions and diversity of people attending MGs can be proactively used to conduct active surveillance of communicable and non-communicable diseases or indicators of global and national public health interest during MGs than can collectively complement efforts to enhance global health security.

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The Gulf countries have made tremendous improvements in their health systems in a short period of time due to extensive investments. However, during the same time period, rapid changes in lifestyle habits led to a changing burden of disease. In this manuscript, we report the burden of disease and risk factors for the Gulf countries (Bahrain, Kuwait, Oman, Qatar, Kingdom of Saudi Arabia, United Arab Emirates, and Yemen) measured by causes of death, years of life lost due to premature mortality (YLLs), years of life lived with disability (YLDs), and disability-adjusted life years (DALYs) for the years 1990 to 2013. Our findings showed a decline of infectious diseases and a rising burden of road traffic accidents and non-communicable diseases while Yemen is still facing a large burden from communicable diseases. Our findings call for the development and implementation of programmes to reduce these burdens and engage other sectors such as the Government and the community in these efforts. These programmes need to be developed and adopted locally since many of the programmes found in the literature may not succeed in the region. Moreover, there is an urgent need for a political will and legislations to ensure their success.

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The title is the main advertisement for an article and enables the reader to decide whether they want to read the article or not. The title should be simple, specific and reflect the article's content clearly and precisely in 10 - 15 words. The abstract summarizes the whole article in 200 to 250 words and should be structured for a research article. It includes the problem or the study objectives, the methods used, the main results obtained and the conclusion reached. Most authors write the abstract last, so that it accurately reflects the content of the article. Keywords are placed below the abstract and are usually 3 - 7 in number. Choosing right keywords will enhance the article being found by other researchers as these are used by abstracting and indexing services. Ultimately, a well-cited research article depends on how well the title, abstract and keywords are written.

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Objective: To assess the awareness of physicians at King Abdulaziz University Hospital (KAUH), a tertiary care centre in Jeddah, Saudi Arabia, about the scope of practice of otolaryngologist (OTL) - head and neck surgeons. Furthermore, to identify diseases of the head and neck in which physicians may underestimate the role of OTLs. Study Design: Cross-sectional analysis. Background: The scope of practice of ear, nose and throat surgeons has impressively widened to include many subspecialities such as head and neck surgery (HNS). Encountering diseases that used to be or could be handled by other surgical specialities may cause confusion among physicians. This confusion may extend to mislead some physicians while referring. Methods: A total of 336 questionnaires were distributed to physicians at KAUH. The questionnaire targeted consultants, specialists and residents of different departments. The survey asked the responders which specialty they believed was the expert in managing certain clinical conditions related to OTLs. The respondents were allowed to choose one or more speciality for each question. Results: One hundred and seventeen questionnaires of the total 336 were analysed with a response rate of 34.8%. The analysis showed that 94.9% of the respondents believed that OTLs were experienced in dealing with pharyngeal lesions. Regarding hoarseness, 96% of the physicians thought that it was a symptom managed by OTLs. About 94% of the respondents chose OTLs as experts in managing patients with a foreign body ingestion. Almost 89% (88.9%) thought that OTLs were the physicians who perform tracheostomies. However, regarding cold or flu and oral lesions, OTLs only scored 68.4% and 64.1%, respectively. Conclusion: The study revealed the awareness of physicians at KAUH in regards to the extent of services provided by OTL-HNS as not fully satisfactory. It is our job as OTLs to raise awareness of our speciality among colleagues of other departments.

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Context: Literature suggests that social anxiety develops due to the complex interplay of multiple risk factors including self-perception and negative life events. We examined the association between these variables and social anxiety among medical students. Aims: The aim is to assess the association of risk factors and social anxiety in medical students. Materials and Methods: In this cross-sectional observational study, 334 medical students were given a semi-structured self-reported questionnaire. It enquired about demographic details: self-satisfaction in terms of weight, body image and facial appearance; six negative life events which were conflict between parents, sexual, physical and emotional abuse, family violence and loss of someone close. Social anxiety was assessed using Liebowitz social anxiety scale (LSAS). Data were analysed using SPSS software (Version 16.0., SPSS Inc., Chicago, IL, USA). Chi-square and Student's t-tests were used for qualitative and quantitative data, respectively. Linear regression analysis was performed to assess association between negative life events and social anxiety scores. The value of P < 0.05 was considered statistically significant. Results: Mean standard deviation (SD) age of sample was 18 (1.04) years. Mean (SD) LSAS score was 33 (20). Linear regression analysis adjusted for age, gender and family psychiatric history revealed positive association between LSAS score and dissatisfaction with body image (P = 0.001), dissatisfaction with facial appearance (P = 0.047), and family violence (P = 0.048). Dissatisfaction with weight showed association with social anxiety in univariate analysis, but it could not sustain on regression analysis. Other negative life events were not significantly associated with LSAS score. Conclusions: Development of social anxiety is significantly associated with dissatisfaction with body image and facial appearance. Exposure to family violence is also an associated factor.

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Background: Traditional teaching dictates that direct laryngoscopy is best performed with the patient's head in the sniffing position. However, of late, many authors have challenged this concept. In a recent meta-analysis, based on studies involving 2759 participants researchers have found that sniffing position affords no added advantage over simple head extension. Our study highlights an important scientific fact overlooked in all previously done studies on the subject. Aim: We aimed to compare sniffing position and simple head extension position for ease of laryngoscopic intubation using an interval scale. Materials and Methods: A prospective single-blind crossover study of 200 patients, where glottic exposure in both positions was compared in the same patient using Cormack-Lehane (CL) grading and percentage of glottic opening (POGO) score. Intubation difficulty was compared using the intubation difficulty score. Results: In every study, CL grading, an ordinal scale, has been used for comparison of glottic exposure. In our set of patients, CL grading showed 'no change' in glottic exposure quality in 85% of the laryngoscopies. When we used POGO system of classification which is an interval scale, for the same laryngoscopies in the same patients, sniffing position improved exposure in 106 patients, whereas simple head extension position improved exposure in 76 patients. Only 18 patients showed no glottic exposure. Statistical Analysis: Two-sample Wilcoxon rank-sum (Mann-Whitney) test and Chi-square tests showed sniffing position to be significantly better position for glottic exposure and for ease of intubation. Conclusion: Sniffing position provides better glottis exposure and it is easier to intubate a patient in the sniffing position as compared to simple head extension position. Sniffing position should therefore be used as initial position when attempting intubation.

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Background: Invasive haemodynamic monitoring is one of the major competencies required for critical care nurses. Critically ill patients need continuous assessment of their cardiovascular system to diagnose and manage complex medical conditions. Aim: This study aimed to assess critical care nurses' knowledge and practice of invasive haemodynamic monitoring in Khartoum government hospitals. Materials and Methods: A descriptive study was conducted. It included ninety critical care nurses who worked in the Intensive Care Units (ICUs) of Khartoum government hospitals that have invasive haemodynamic monitoring system. The study extended from March 2013 to April 2014. Data were collected from ninety critical care nurses working in selected ICUs; using a validated questionnaire. The data were analysed by the Statistical Package for Social Services Version 20. Results: The results showed that availability of written protocols regarding invasive haemodynamic monitoring within ICUs was low (34.3%). The overall knowledge of critical care nurses (who participated in the study) about invasive haemodynamic monitoring was not acceptable. The results also showed that the estimated total practice of the registered nurses who participated in the study was either fair (75.6%) or poor (24.4%). This study indicated that critical care nurses' knowledge was poor to fair and that of registered nurses' practice was poor. Conclusion: The study showed unacceptable level of nurses' knowledge on haemodynamic monitoring. The nurses' practice about was poor.

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Purpose: The purpose of this study was to evaluate the following research questions: (1) What are dental students' perceptions of their clinical training in an integrated curriculum? and (2) What are the students' confidence levels in performing routine dental procedures? Materials and Methods: A cross-sectional study was conducted among 32 undergraduate students in the last 2 years of the dental program in April 2015 at the College of Dentistry, Aljouf University. The survey included 16 items that describe dental students' confidence levels in performing various clinical procedures. Data were analysed using univariate, bivariate and multivariate analyses, as indicated. Results: Students demonstrated high levels of confidence in performing routine clinical procedures, whereas the 5 ^th year students were more confident in interpreting radiographs, giving oral hygiene instructions, performing extractions and restorative treatments, as well as fabricating removable complete dentures. The mean confidence level among students in performing clinical procedures was 2.9 (standard deviation = 0.48). The mean confidence level significantly increased among the 5 ^th year students compared to their 4 ^th year counterpart (P = 0.005), while the effect of grade point average and number of weekly hours devoted to the study was not significant. Conclusion: In the integrated curriculum, our study highlights the importance of clinical training not only in making dental students competent but also in increasing their confidence in performing clinical procedures.

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Getting research into practice requires the integration of explicit knowledge, often called evidence and obtained from research, with tacit knowledge obtained from the experiences of healthcare professionals in their daily practice. This integrated "useful knowledge" informs decision-making by professionals and produces change in clinical practice. Responding to this challenge requires both the creation of explicit knowledge that is "useful", including commissioning and performing research that is highly relevant to healthcare professionals in their daily practice, and developing opportunities for healthcare professionals to create and share their tacit knowledge, such as through action research groups.

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