bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cartilage Ear Piercing Probable Infections among Females between 18 and 28 Years Old in Riyadh
Authors: Binkhamis Khalifa , Habib Hanan A. , Alkahtani Mashel K. , Alrasheed Dana A. , Barakeh Maha M. , Alohali Lina Mohammed , Aloqayfi Sumayah I. 
Published: September 2024

Background:
The prevalence of ear piercings is 8%−32%. Complications can be due to the factors such as the amount of tissue blood supply, the location of the piercing, the extent of hygiene techniques, and much more.

Materials and Methods:
A total of 586 females (age, 18–28 years) in Riyadh, Saudi Arabia, with at least one ear piercing were included in this analytical cross-sectional study by convenience sampling from September 2019 to April 2020. A link to an Arabic web-based questionnaire was distributed through social media (WhatsApp, Twitter, and Snapchat). It included questions related to both earlobe and ear cartilage piercings. Bivariate statistical tests were carried out.

Results:
The prevalence of a probable ear piercing-related infection for ear cartilage piercings was found to be significantly higher than for earlobe piercings (41.4% vs. 29.6%) (P = 0.0004) (confidence interval [CI] = 0.443–0.795). A significant association between piercing type (3.3% of earlobe piercings and 8.1% of ear cartilage piercings) and scar formation was observed (P = 0.0002) (CI = 0.209–0.722). The prevalence of ear piercing complications among participants who used piercing needles was lower for both earlobe piercings and ear cartilage piercings (3.65%, 8.75%) (P = 0.0015) than among those who used piercing guns (37.9%, 43.4%) (P = 0.114).

Conclusion:
Probable external ear infections were more common among those with cartilage ear piercings than those with earlobe piercings. Future studies should include participants of a broader age category and in different locations in Saudi Arabia.
Prevalence of Constipation among Peritoneal Dialysis Patients in Saudi Arabia
Authors: Tarakji Ahmad Raed , Alorabi Hussam Zaid , Alhusainy Yazeed Abdullah , Alhowaish Nasser Yousef , Alsebti Abdullah Abdulaziz , Aljutaili Hamad Sulaiman 
Published: September 2024

Objectives:
Constipation among peritoneal dialysis (PD) patients can lead to serious complications and impair the quality of life. The aim of this study was to determine the prevalence of constipation and its associated factors among PD patients in our center.

Methods:
A quantitative, cross-sectional study was conducted on PD patients at King Khaled University Hospital in Riyadh, Saudi Arabia, from November 2016 to January 2017.

Results:
A total of 36 PD patients were included; the male to female ratio was 1. Based on a self-reporting questionnaire, 15 PD patients (41.7%) reported suffering from constipation. However, the prevalence was the same using at least one of Rome III criteria (41.7%) and much lower using Bristol stool form Scale (11%). No significant difference was detected between PD patients with and without constipation in terms of dietary fiber intake, use of calcium and iron supplements, water intake, presence of diabetes and hypertension, or demographic profiles.

Conclusion:
The high prevalence of constipation among PD patients seen in our population is comparable to those seen in other studies.
Renal-dose Dopamine Postcardiac Surgery in Patients with Acute Kidney Injury
Authors: Albacker TB , Alqumaizi F , Alqazlan A , Alghamdi FK , Arafat AA 
Published: September 2024

Background:
Many studies have investigated the prophylactic use of dopamine in cardiac or critically ill patients with controversial results. However, only very few studies investigated the therapeutic use of low-dose dopamine in cardiac surgery patients after the development of acute kidney injury (AKI). Therefore, the aim of our study was to investigate the effect of postoperative use of low-dose dopamine in patients who develop AKI postcardiac surgery on improvement in renal function.

Methods:
This is a retrospective cohort study that included all adult patients who underwent cardiac surgery with the use of cardiopulmonary bypass and developed AKI between January 2017 and December 2020. Ninety-six patients were enrolled in the study and were divided into two groups; the first group who did not receive postoperative renal-dose dopamine (39 patients) and the second group who received dopamine (57 patients). The outcomes of interest were the improvement in renal function as indicated by the serum creatinine level, the requirement for dialysis, and the 30-day mortality.

Results:
The dopamine group had higher postoperative peak creatinine levels (205 vs. 164, P < 0.001) and higher requirements for dialysis (22.81% vs. 2.56%, P = 0.01) compared to the nondopamine group. In addition, the dopamine group had longer duration of intubation (24 h vs. 21 h, P = 0.01), longer requirement for inotropic support (4 days vs. 3 days, P < 0.001), and higher rate of re-exploration for bleeding or tamponade (21.05% vs. 2.56%, P = 0.01). Multivariate regression analysis showed that time from surgery was the only factor associated with an increase in creatinine level while dopamine use was not associated with an increase or decrease in postoperative creatinine level.

Conclusion:
The use of low-dose dopamine was not effective as a therapeutic agent in improving renal function or eliminating the need for dialysis in patients who develop AKI postcardiac surgery.
An Assessment of Learning Styles of Undergraduate Medical Students in Three Different Types of Curriculum
Authors: Alfawzan Abdulrahman , Mahzari Moeber , Agha Sajida , Omair Aamir , Alfawzan Omar , Alessa Reema , Alturki Abdulaziz , Alshiha Kholoud 
Published: September 2024

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.
Effectiveness of Online Peer-Assisted Learning Session in Fostering the Knowledge on Breast Cancer and Breast Self-Examination among Undergraduate Medical Students
Authors: Ranganath R , Simon MA , Shah YA , AlAbduwani FI , Al Mubarak H , Al-Shamsi FA 
Published: September 2024

Introduction:
Peer-assisted learning (PAL) is a student-centered active learning process which provides a flexible approach for students to prepare and organize their learning prospectus and gives opportunity for collaboration among peers.

Aims:
The purpose of this study was to assess the effectiveness and impact of online PAL session in enhancing the knowledge of breast cancer and breast self-examination (BSE) among medical students.

Settings and Design:
This was a cross-sectional, quasi-experimental study done using mixed-method design.

Subjects and Methods:
Online PAL session was conducted for premedical and preclinical students by the peer tutors for 93 medical students in March 2020. Knowledge of breast cancer and BSE was compared with the pretest and posttest scores. Feedback survey from tutees, tutors, and faculties was taken to evaluate conduct and satisfaction of the workshop for improvements in future.

Statistical Analysis Used:
Data were analyzed using SPSS 22. Descriptive data were presented as frequency and percentage. Continuous data were presented as mean and standard deviation. Paired sample t-test was applied for statistical significance of pretest and posttest data.

Results:
Significant improvements were observed in the posttest scores of knowledge on breast cancer and BSE. The mean satisfaction score was high among the tutees, tutors, and faculties, indicating that PAL session had significant impact on students.

Conclusions:
PAL sessions can be a dynamic tool to create a safe and successful learning environment for students to learn on sensitive health issues such as breast cancer and BSE.
Colorectal Cancer Surveillance after Resection
Authors: Aloun Abdulrahman A. , Alnafisah Khaled A. , Azzam Nahla , Aljebreen Abdulrahman , Alotaibi Egab , Alkhathami Mohammad , Mahrous Waleed K. , Alghamdi Abdullah A. , Alhujairy Bandar A. , Al Badr Eldin , Obeidalah Ibrahim , Almadi Majid Abdulrahman 
Published: September 2024

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.
Shear Bond Strength of Ceramics to Chlorhexidine versus Pomegranate Peel Extract – Pretreated Dentin: A Randomized Control Study
Authors: Zaghloul Samaa A. , Gabal Zahraa A. , Abdul-Rahman Fatma Al-Zahraa M. 
Published: September 2024

Background:
Durable tooth bonding is the hallmark of successful minimally invasive all-ceramic restorations.

Aim:
The aim of this study was to assess the shear bond of ceramics to pretreated dentin with chlorhexidine (CHX) or pomegranate peel extract (PPE), compared to no pretreatment (control), after thermocycling.

Materials and Methods:
Thirty extracted sound human premolars were enrolled and mounted in autopolymerized acrylic blocks. Occlusal 3 mms were removed to obtain the flat dentin surfaces. Teeth were randomly distributed among three equal groups (n = 10) according to dentin pretreatment; (group I: No pretreatment (control), group II: 2% CHX, and group III: PPE pretreatments). Ceramic discs (4 mm × 4 mm × 1.5 mm) were milled from zirconia-reinforced lithium silicate (ZLS) blocks (Celtra Duo, Dentsply), and cemented to prepared teeth with self-adhesive cement (RelyX Unicem, 3M). All samples were thermocycled for 2500 cycles at 5°C–55°C. Shear bond strengths (SBSs) were assessed followed by statistical analysis using one-way ANOVA, followed by Tukey’s post hoc test. The significance level was set at P ≤ 0.05 in all tests.

Results:
CHX-pretreated group showed the best SBS (18.40 ± 1.27 MPa) after thermocycling, compared to control (12.24 ± 1.20 MPa) and PPE-pretreated groups (5.89 ± 0.24 MPa) with a statistically significant difference among all groups (P ≤ 0.05).

Conclusions:
In contrary to PPE, CHX-dentin pretreatment kept better SBS to ceramics after thermocycling, providing an access to minimally invasive, yet durable esthetic restoration.
Contemporary Trends and Ethical Concerns in Clinical Photography in Saudi Arabia
Authors: Jamal Amr , Al Ghamdi Khalid M. , Tharkar Shabana , Al-Rabiah Ibrahhem , Al-Shehri Mohammed , Al-Sahaf Abdulmalik , Al-Baz Mohammed , Al-Rowailey Abdullah , Al-Fowzan Abdulrahman 
Published: September 2024

Objectives:
Medical photography is imperative for maintaining documentation of patient records and aiding in diagnosis and management, research, education, and training. Smartphones have replaced conventional photography due to their ease of availability, accessibility, and storage; however, their use raises privacy and ethical concerns. The objective of the present study was to determine the current trends in clinical photography and to assess the ethical issues involved in this field.

Methods:
A cross-sectional survey was used to interview physicians registered at the Saudi Commission for Health Specialties. Data collection was performed using the SurveyMonkey platform, and the final sample included complete responses from 210 participants.

Results:
A total of 147 physicians (70%) reported taking clinical photographs. Personal smartphones were the most common device used by 116 (79%) physicians, and 43 (29.3%) reported also using hospital cameras for photographing their patients. Patient visit follow-ups and medical education/training were the most popular reasons for clinical photography. Access to these devices was not well secured, with only 42 (28.6%) physicians reporting storing them in a separate folder with a password. Furthermore, no significant differences were observed in consent-taking practices between male and female patients and in the cross-analysis between physicians' and patients' genders. However, significant differences were obtained in the method of consent for identifiable and nonidentifiable photographs, with written consent preferred over verbal in identifiable photographs (P = 0.025). Common misuses included not obtaining proper consent before taking and while sharing the photographs, which raises serious privacy concerns. Patients' refusal to be photographed was the most common barrier reported by 55 (26.2%) physicians.

Conclusions:
Physicians mostly resorted to personal smartphones for capturing and storing patient photographs. This study identified a widespread prevalence of inadvertent practices related to inadequate consent, photograph sharing, and unsecured storage, which increases the risk of a breach of confidentiality. There is an urgent need to enforce standard guidelines and regulations addressing patients' privacy and ethical concerns involving digital photography in clinical practice.
Driving Distance and Glycemic Control in Patients with Insulin-Treated Diabetes Mellitus
Authors: Almigbal Turky H. 
Published: September 2024

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.
Studying the Anthropometric Indices of University Students at a Nigerian University
Authors: Ugbenyen Anthony Moses , Ajayi Olulope Olufemi 
Published: September 2024

Background:
Measurement of an individual’s anthropometric indices is one of the many methods for determining physical health status. This study was designed to test the reliability of some anthropometric indices in predicting central obesity among undergraduate students in Edo State, Nigeria.

Materials and Methods:
Random sampling was used in recruiting 843 undergraduate students aged 15–31 years old from Edo State University, Uzairue, Edo State, into this cross-sectional study. Traditional and new Anthropometric indices were determined by standard methods, and the area under the curve (AUC) was calculated. Data were analyzed using Student’s t-test, Chi-square, and Mann–Whitney test, and correlations were determined and were deemed statistically significant at P < 0.05.

Results:
The majority of males (52.5%) and females (50.7%) were aged 19–22 years. Weight, height, waist circumference (WC), and mid-upper arm circumference (MUAC) were significantly higher in males than females (P < 0.05). Conversely, body mass index (BMI), body roundness index (BRI), and body adiposity index (BAI) were significantly higher in females compared to males (P < 0.05). The female participants had significantly higher pulse rates, oxygen saturation, and pulse pressure than the males (P < 0.05). The AUC constructed showed WC and Waist–height ratio predicted central obesity in both genders (AUC ≥ 0.9). A significant positive correlation of WHtRatio with MUAC was observed in female participants, while a significant inverse correlation was observed between BAI and a body shape index in male participants in this study.

Conclusion:
Determining cutoff values for these indices, particularly in adolescents in sub-Saharan Africa, is imperative.
Understanding the Residents’ Practice of Cause of Death when Completing Death Certificates in Saudi Arabia
Authors: Aljerian Khaldoon , AlHogail Norah Salah , Alsuhaibani Adel Abdulaziz , Alhamidi Razan Ali 
Published: September 2024

Background:A death certificate is an official certificate signed by a doctor that states the cause of a person’s death. In most teaching hospitals, resident physicians complete the filling out of death certificates.Materials and Methods:In this research study, we conducted a cross-sectional study on 300 resident physicians from subspecialties, such as internal medicine, emergency medicine, and surgery, at King Khalid University Hospital, Riyadh, Saudi Arabia. The residents responded to a self-administered questionnaire. Both male and female physicians voluntarily participated in the study upon providing electronic consent. The Statistical Package for the Social Sciences(SPSS) version 25 was used to measure the statistical significance of the retrieved responses.Results:The study conveys that in the last 12 months, 8% of the study participants had not filled out any death certificates. Moreover, in the last 3 years, 74.6% of the resident doctor participants had filled out a significant number of death certificates, while only 4.3% had not dealt with this document. Only 16% of the doctors filled out a death certificate for patients for whom they were the primary caregivers in most of the cases.Conclusion:The data generated through this study indicated the reasons why some inaccuracies occur in the process of filling out death certificates, which are based on the reasons accepted by the system, the language barrier, and the training received by the residents on the matter. Given these study results, we have made various recommendations for a training program based on the documented challenges and inaccuracies in filling out death certificates, irrespective of any prior training in the subject.