Ahmad Abdul Azeem Abdullah Omer

Culture and context are increasingly recognized in debates on the globalization and standardization of medical curricula. This study explored how cultural and contextual factors shaped students' and mentors' experiences of portfolio-based learning in a Middle Eastern setting. An explanatory sequential mixed-methods design was used. Ethical approval was obtained. Participants were clinical-year medical students during their clerkships at Prince Sattam Bin Abdulaziz University, Saudi Arabia. A questionnaire assessing perceived cultural and contextual influences on portfolio-based learning was developed and validated. Student group discussions and mentor interviews explored perspectives. Survey data were analyzed using descriptive statistics, Spearman's correlation coefficients, and multiple regression analyses. Qualitative data were analyzed thematically within cultural and contextual domains. A total of 111 students completed the survey (response rate 78.7%), and qualitative data comprised group discussions with 79 students and interviews with six mentors. Students rated portfolio usefulness at 4.17 (SD ± 3.13) on a 10-point visual scale, indicating low perceived educational value. Perceived portfolio usefulness was positively associated with training level (ρ = 0.626, p < 0.001), appeared to be negatively associated with uncertainty avoidance (ρ = -0.79, p < 0.001; B = -1.01, p = 0.002), and positively related to long-term orientation (B = 1.69, p < 0.001). Qualitative findings clarified cultural and contextual influences on portfolio engagement. Students demonstrated high uncertainty avoidance, collectivist learning preferences, and short-term goal structures, with variable orientation regarding power distance. Significant associations were observed between cultural dimensions, students' perceptions of portfolio usefulness, and training level. Contextually, students perceived limited alignment between portfolios and the formal curriculum and described the hidden curriculum and learning environment as influential in shaping engagement. Sociocultural and contextual factors appeared to shape experiences of portfolio-based learning. Recognizing these influences may support more acceptable and meaningful portfolio implementation in diverse medical education settings.

Stomach adenocarcinoma is a major contributor to worldwide mortality and poses a substantial challenge to improving life expectancy. The main objective of the current work was to identify diagnostic and prognostic biomarkers in stomach adenocarcinoma in order to advance translational medicine and patient outcomes. By accomplishing this objective, the research seeks to provide significant insights into the field of translational medicine. Seven novel unfavourable prognosis-associated genes (NALCN, CALCR, CPT1C, ELAVL3, FLJ16779, MYOZ3, and TPST1) were first identified. Additionally, 41 potential miRNAs were predicted. ELAVL3-hsa-mir-29a-3p and CALCR-hsa-mir-29a-3p axes were identified as two critical pathways in the carcinogenesis of stomach adenocarcinoma via a bioinformatics analysis. Following that, lncRNAs binding to hsa-mir-29a-3p were predicted via starBase and miRNet databases for predicting lncRNA binding sites. After conducting both expression and survival analyses for these predicted lncRNAs, we found that only one lncRNA (KCNQ1OT1) was markedly overexpressed in stomach adenocarcinoma, and its elevated expression was associated with an unfavourable prognosis. Next, we established a comprehensive mRNA-miRNA-lncRNA triple ceRNA network linked to the prognosis of patients with stomach adenocarcinoma. In summary, the current study provides an extensive ceRNA network that highlights novel diagnostic and prognostic biomarkers for stomach adenocarcinoma.

Objectives: To investigate the epidemiological and clinicopathological features of breast cancer (BC) in Saudi Arabia to improve decisions regarding resource allocation, disease control, and management. Methods: We retrieved the records of all patients who presented with histologically proven BC at King Fahad Medical City between 2019 and 2020. The data were analyzed quantitatively, and the results were expressed as percentages and frequencies. Results: This study comprised 419 patients. The mean age was 50.13 (± 10.96) years. The majority of the patients were obese (56.6%), and approximately a quarter had a history of oral contraceptive pill use, breast biopsy, or an affected family member. Most cases were from the central region (80.1%), followed by the southern provinces (12.7%). Breast lumps were the most common complaint (89%), whereas hypertension and diabetes mellitus were the most common comorbidities. Invasive ductal carcinoma was the most common pathologic type (89.7%). Most patients presented with TNM stages II and III (55.2%), and 27.7% had metastasis. The main therapeutic modalities included radical mastectomy (63.8%), neoadjuvant chemotherapy (60.4%), and adjuvant radiotherapy (82.9%). Conclusion: In Saudi Arabia, a trend of BC incidence migration towards older patients may be ensuing. However, prediction of an advanced and aggressive presentation requires the enhancement of screening programs and standardized protocols for disease management.

The coronavirus disease 2019 (COVID-19) is a serious global pandemic that has extremely affected health-care systems. This article aimed to review the perspectives of general surgical practice during the COVID-19 pandemic. A systematic review of the literature addressing modification to general surgical practice during the COVID-19 pandemic indexed in PubMed, Scopus, Google, and Google scholar was carried out on June 19–20, 2020. The literature review yielded 577 articles. The exclusion of duplication, articles not in English, and specialized ones in various surgical disciplines precluded 398 articles. Finally, following checking for relevance and publication status, 114 papers were included. Recommendations for surgical practice during the COVID-19 pandemic revolved around mitigation of the risk of virus transmission to patients and health-care workers. The emerging themes of safety precautions were related to patient prioritization and testing, mindful consideration of the operative strategy, optimum use of personal protective equipment, operative room setup, and departmental organization. However, those recommendations were often diverging and bore on a dearth of evidence and personal opinions. Multidisciplinary work and cooperation among surgical specialties are required to establish and validate the protocols for safe surgical practice during the pandemic and perhaps similar crises in future. The COVID-19 pandemic has brought several challenges to the field of medicine, including the surgical specialty. The centrality of safety precautions emerging in this crisis requires surgeons to adopt the new roles and work standards and translate them into practice during the pandemic and perhaps longer.

Background: Colorectal cancer (CRC) is common in the Kingdom of Saudi Arabia (KSA) and worldwide. Tabuk region, in the Northwest part of Saudi Arabia, is one of the regions with the highest incidence of the disease in the Kingdom. Objective: This study aims to compare the clinicopathological features of CRC between the young and elderly patients in Tabuk region. Methods: This is a retrospective, hospital-based, descriptive study conducted at the three main referral hospitals in Tabuk region over 5-year period between 2010 and 2014. All patients diagnosed with CRC proved with histopathology were retrieved and categorized into two groups; group one (less than 40 years of age) and group two (equal to or older than 40 years of age). The clinical and pathological features of the disease were compared between the two groups. Results: The study involved 72 patients 94.4% of whom were Saudi and 5.6% were from the South East population. Group one comprised 10 patients (13.9%) while group two were 62 (86.1%). The male to female ratio was 1.5 for group one and 1.7 for group two. Adenocarcinoma was the predominant histological type in both groups (98.6%). Lefts-sided tumours were more common in both groups (74.2 and 70%) however; a greater proportion of the patients in group 1 had more right-sided tumours (30%) than their elderly counterparts (25.8%). Advanced tumour presentation (Duke`s C+D) was more common in group 1 (90%) than in group 2 (83.8%). However, differences between the two groups was not statistically significant. Conclusion: CRC is less common among the young population in Tabuk region than other parts of Saudi Arabia and some regional countries. Demographic and genetic studies are advocated in the area to provide further explanation of these results.

Background : Violation of item-writing guidelines is still frequently encountered in assessments in medical colleges. Flawed multiple-choice (MC) items affect students' performance and distort examinations' results. Aims: The aim was to assess the frequency and impact of flawed MC items on students' achievement in our setting. Settings and Design: This is a quantitative descriptive study conducted at the Faculty of Medicine in the University of Tabuk, Saudi Arabia. Methods: We evaluated a 100 single-correct answer MC questions summative surgical examination administered to 44 6 ^th year final medical students in November 2014. MC items, which contain one or more violation of item-writing guidelines, were classified as flawed, those with no violation, were classified as standard. The passing rates and median scores of high- and low-achieving students were calculated on both standard and flawed test scales. Item performance parameters (difficulty index, discrimination power and internal consistency reliability (Kuder-Richardson formula 20) were calculated for standard and flawed items. Descriptive and comparative statistics with the relevant tests of significance were performed using the SPSS (IBM SPSS Inc. Chicago, Illinois) computer software version 16. Results: Thirty-nine flawed items were identified (39%) which contain 49 violations of the item-writing guidelines. The passing rate was 93.2% and 91.8% on the total and standard scales, respectively. Flawed items benefited low-achieving students and disadvantaged the high-achieving students. Overall, flawed items were less difficult, less discriminating and less reliable than standard items. Conclusions: The frequency of flawed items in our examination was high and reflects the need for more training and faculty development programmes.