Baraa Alghalyini

Background: Pre-clerkship Family Medicine teaching often covers content well but does too little with experiential immersion, structured reflection, and the open engagement with clinical uncertainty that defines generalist work in practice. We describe the partnership-based redesign of the COM353 Family Medicine and Primary Care block at Alfaisal University, Riyadh, with student-reported outcomes from the first delivered cohort. The paper is offered as a worked account of how academic-academic and academic-service partnerships can themselves become curriculum. Pedagogical framework: The redesign rests on three commitments developed in dialog with the Department of Family and Community Medicine at the University of Toronto: generalism as a clinical method that has to be taught deliberately, clinical courage as a disposition that can be cultivated, and community-based practice as a primary site of clinical learning. Teaching is built around an iterative concept-experience-reflection cycle, with didactic sessions, structured Primary Health Care Center placements, simulation, problem-based learning, and reflective writing. Learning environment and pedagogical format: COM353 is a four-week mandatory block for third-year medical students delivered through formal partnerships with Primary Health Care Centers in Riyadh and aligned with Saudi Arabia’s Vision 2030 health workforce priorities. Learning objectives target seven domains spanning generalist competencies, experiential learning, uncertainty tolerance, reflection, and systems thinking. Preliminary results from the first delivered cohort: A post-block survey of the January 2026 cohort produced 96 completed responses (response rate 76.2%). Domain means ranged from 3.90 to 4.27 on a five-point Likert scale, with Cohen’s d 0.92 to 1.58. Multiple linear regression identified Systems Thinking ( β = 0.727), Reflection ( β = 0.295), and Learning Environment ( β = 0.293) as significant predictors of overall block satisfaction, in a model explaining 78.2% of the variance. Discussion and implications: A pre-clerkship block built on explicit pedagogy and run through partnership was associated with coherent, favorable student-reported outcomes across the competencies it set out to develop. That systems thinking emerged as the dominant predictor matters for design: when students grasp healthcare as a system, the rest of the curriculum lands harder. The model has practical relevance for medical schools in Gulf and other LMIC settings working toward PHC-centered health system reform.

The 2018 Declaration of Astana reaffirmed Primary Health Care (PHC) as the foundation for universal health coverage and the health-related Sustainable Development Goals, yet the workforce, curricula, and research infrastructure required to deliver that vision remain unevenly developed across regions. This narrative review, prepared in line with the SANRA reporting standard, examines the global field of academic partnerships for family medicine (FM) and PHC education during the 7 years that followed Astana. We synthesize peer-reviewed and gray literature from 2010 to April 2026 across PubMed, Semantic Scholar, ERIC, and the principal FM and global health journals, and we map the evidence to the World Health Organization three-component PHC framework and Starfield’s 4Cs of primary care. We propose a five-modality typology, the AP-PHC Typology, that distinguishes bilateral North-South capacity-building partnerships, multi-institutional North-South networks, South-South peer-learning networks, triangular partnerships, and multilateral convening platforms. Each modality is mapped to its distinctive contribution across the 4Cs and to the WHO components of integrated services, multisectoral action, and community empowerment. The evidence shows that South-South networks such as PRIMAFAMED, the Iberoamerican Confederation of Family Medicine, AfriWon Renaissance, and the South Asian primary care research community have produced contextually grounded curricula, faculty development pathways, and emerging research traditions. North-South initiatives, in turn, have made measurable but uneven contributions to faculty capacity, often constrained by short donor cycles and asymmetric authorship, with cultural translation rarely fully achieved. Academia is the engine room of post-Astana implementation, but only when partnerships are governed by explicit ethical principles, equitable authorship norms, and sustained financing aligned to country priorities. We close with a falsifiable proposition: where academic FM partnerships explicitly embed the Besrour ten ethical principles and demonstrate equitable LMIC-led authorship, program sustainability beyond donor cycles is significantly more likely than where these conditions are absent. Testing this claim should anchor the next decade’s research agenda.

Background: Lower urinary tract symptoms (LUTSs) are among the most common urological complaints in older men, frequently arising from benign prostatic hyperplasia (BPH) or prostate cancer (PCa). While both conditions share overlapping symptomatology, the way each condition progresses and is managed differs considerably. In sub-Saharan Africa, data on the relative burden of BPH and PCa among men presenting with LUTSs are scarce. This study aimed to determine the prevalence of histologically confirmed BPH and PCa among men presenting with LUTSs at a major tertiary referral center in Tanzania and to explore the association between specific urinary symptoms and histopathological diagnoses. Methods: A retrospective cross-sectional study was conducted at Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania, reviewing medical records of adult male patients aged ≥50 years who presented with LUTSs and underwent prostatic biopsy between January and December 2023. A total of 133 patients were included through simple random sampling from an eligible population of 260. Data on demographics, comorbidities, International Prostate Symptom Score (IPSS), serum prostate-specific antigen (PSA), prostate volume, and histopathological biopsy outcomes were extracted using a purpose-built digital form. This study was conducted in compliance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Results: Most patients (39.8%) were aged 70 to 79 years. Hypertension was the most frequent comorbidity among those with chronic disease (31.65%), followed by diabetes mellitus (12.03%). The mean serum PSA was 465.1 ng/mL (SD = 1610.1), and the mean prostate volume was 80.6 cm³ (SD = 75.6). Histopathologically, 57.9% of biopsies were benign and 40.6% were malignant. The most commonly reported IPSS symptoms were urinary frequency (78.2%), weak stream (78.2%), and incomplete emptying (64.7%). Most patients (59.4%) had severe IPSSs. Statistically significant associations were observed between biopsy outcomes and incomplete emptying (p = 0.011), frequency (p = 0.014), weak stream (p = 0.022), nocturia (p = 0.001), urge incontinence (p = 0.004), and post-void dribbling (p < 0.001). IPSS severity was significantly associated with biopsy diagnosis (p < 0.001), with 63% of malignant cases presenting with moderate symptom scores. Conclusions: BPH was the predominant histopathological diagnosis among men presenting with LUTSs at this tertiary center, while prostate cancer accounted for a substantial minority of cases. Certain individual LUTSs, particularly nocturia, urge incontinence, and post-void dribbling, demonstrated significant associations with malignant histopathology. These findings underscore the necessity for systematic histopathological evaluation in all men presenting with LUTSs in resource-limited settings, irrespective of symptom severity.

Medical student-led health promotion projects are pivotal in enhancing community health and medical education. However, research focusing on the impact of such projects on medical students' knowledge translation skills is limited. This study aims to address this gap by developing and validating a survey tool to assess the knowledge translation skills and overall impact of a student-led health promotion project. We designed and validated a comprehensive survey questionnaire. The tool underwent rigorous exploratory factor analysis, content and face validity checks, and reliability testing. A cross-sectional survey was conducted among medical students participating in a Health Promotion Project Exhibition at Alfaisal University, Riyadh, Saudi Arabia. The survey explored students' perceptions of skill development and knowledge translation effectiveness. The finalized questionnaire consisted of 33 items across four domains: preparation and organization, public education and communication, personal and professional development, and overall experience. The questionnaire demonstrated high reliability (Cronbach's alpha ranging from 0.871 to 0.968 across domains). The analysis indicated positive student perceptions across all domains, with emphasis on skills in literature search, evidence-based medicine, communication, and teamwork. The study successfully developed a validated survey tool for assessing the impact of health promotion projects on medical students' knowledge translation skills. The positive outcomes suggest such projects significantly contribute to skill development in medical education. This tool could be utilized annually to monitor and enhance the effectiveness of health promotion projects, aligning with broader educational goals in public health and community medicine. Not applicable as this study did not involve a clinical trial.

Background: Obesity is a growing public health concern worldwide, and Saudi Arabia faces rising rates of obesity-related conditions, including diabetes and cardiovascular diseases. Bariatric surgery is a recognized treatment for severe obesity, offering significant health benefits. This study evaluates the Saudi population’s awareness and attitudes towards bariatric surgery, examining knowledge levels, perceptions, and potential barriers. Methods: A cross-sectional survey was conducted among adults in Riyadh using convenience and snowball sampling. The survey included demographic data, awareness of obesity and bariatric surgery, attitudes towards the procedure, perceived barriers, and willingness to consider surgery. Data were analyzed using descriptive statistics and logistic regression. Results: Among 313 participants (mean BMI 26.98 kg/m²), 41.9% identified obesity as a disease, and 48.9% recognized the effectiveness of bariatric surgery for severe obesity. Knowledge scores averaged 4.08 (out of 5) for obesity and 3.28 (out of 6) for bariatric surgery. Significant associations were found between bariatric surgery knowledge and gender (p < 0.001), BMI (p = 0.004), income (p = 0.025), and educational level (p = 0.001). While 71.2% would not consider surgery, misconceptions about risks, stigma, and cost remain common barriers. Conclusions: Although awareness of bariatric surgery in Saudi Arabia is moderate, misconceptions about safety and financial constraints persist. Public education campaigns are necessary to dispel myths, improve understanding, and promote bariatric surgery as a viable treatment option for severe obesity. Expanding insurance coverage and financial support may also enhance accessibility and adoption of this life-saving intervention.

Background: Tobacco use significantly impacts health and economic sectors. In the Maldives, 4 out of 10 men smoke daily, despite anti-tobacco policies. The Maldives Global Youth Tobacco Survey (GYTS) shows fluctuating cigarette smoking prevalence among secondary school students: 6.9% (2004), 3.8% (2007), 4.3% (2011), and 4.7% (2019). No studies have investigated smoking prevalence and attitudes toward anti-smoking policies among higher-secondary students in Addu City. This study examines smoking habits, susceptibility, and attitudes toward anti-smoking regulations to support policy development. Methods: We conducted an observational cross-sectional study using a self-administered survey based on the GYTS and the Canadian Student Tobacco, Alcohol and Drugs Survey (CSTADS), involving 335 high school students in Addu City. Variables included sociodemographic factors, ever-smokers, current smokers, age at first cigarette, smoking dependency, use of other tobacco products, smoking susceptibility, willingness to quit, and reasons to quit or not smoke. Results with p-values < 0.05 were statistically significant. Results: 22.8% of the students had tried smoking, with 4.74% currently smoking, predominantly males. Additionally, 32.2% had tried e-cigarettes. Smoking susceptibility was 44.2%. Seven students showed smoking dependency, with a significant gender difference (75.4% boys vs 33.3% girls, p < 0.05). Among smokers, 20% wanted to quit, and 70% cited cost as a deterrent. Only 20% of smokers supported a total ban on smoking in media compared to 49.8% of non-smokers (p = 0.03). Non-smokers significantly supported anti-smoking measures (73% vs 12.5% of smokers). Conclusion: Cigarette smoking among high school students in Addu is below the national average, but the high number of ever-smokers and interest in smoking and e-cigarettes suggest potential future increases. Policymakers should enact stronger legislation, enforce age restrictions, raise tobacco taxes, and implement comprehensive smoking cessation programs to address tobacco use effectively.

Objectives: To examine the distribution, clinical characteristics, and management of priapism in a Saudi Arabian tertiary care setting to provide a regional perspective. Subjects and Methods: This retrospective chart review included 29 male patients presenting with priapism at a tertiary care hospital in Riyadh, Saudi Arabia, from January 2011 to June 2023. Data were collected on patient demographics, clinical presentation, treatment modalities, and outcomes. Results: The study found recurrent episodes of priapism in many patients, with a significant number associated with hematological diseases, notably sickle cell disease. Most treatments involved non-surgical methods. A notable finding was the correlation between the duration of priapism episodes and the likelihood of hospital admissions, suggesting that prolonged episodes often required more extensive medical attention. Conclusions: Priapism often presents as a chronic and recurrent condition requiring personalized management strategies. This study emphasizes the importance of recognizing regional occurrence patterns to enhance the management of priapism and suggests a need for further research in regions where this condition is less common.

Background: The increasing prevalence of chronic diseases in Saudi Arabia has heightened the need for organ transplantation; however, the donor pool remains insufficient. This study explored awareness and willingness towards organ donation among Riyadh residents and examined the sociodemographic factors influencing these attitudes. Methods: A cross-sectional survey using convenience sampling was conducted among adults in Riyadh. The survey assessed demographic characteristics, awareness, willingness to donate, and sociodemographic factors. Statistical analyses included descriptive statistics and logistic regression. Results: Among the 645 respondents, 56.4% were willing to donate organs, with females showing a higher propensity than males (OR 2.9, 95% CI 1.7–5.1, p < 0.001). Awareness of organ donation centers was linked to increased willingness to donate (OR 1.5, 95% CI 1.1–2.5, p < 0.001). Higher educational level was strongly associated with donor registration (OR 36.8, 95% CI 14.7–91.9, p < 0.001). Despite their high willingness, only 9.5% were registered as donors, highlighting the gap between intention and action. Conclusions: Riyadh residents showed a significant willingness to donate organs, influenced by gender, education, and awareness. Low registration rates suggest barriers such as religious beliefs and lack of information. Targeted educational campaigns and policy evaluations, including an opt-out system, are recommended to enhance registration rates.

Background: Cardiovascular disease (CVD) is a leading cause of global mortality. Early intervention and prevention of CVD depend on accurately predicting the risk of CVD. This study aimed to investigate the association between the TyG index and the risk of coronary heart disease (CHD), congestive heart failure (CHF), heart attack (HA), stroke, and hypertension (HTN) among patients without diabetes in the United States. Methods: In this retrospective, cross-sectional study, we used data from the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2020. We conducted several regression analysis models and calculated the sensitivity and specificity of (TyG) index for predicting the onset of CHD, CHF, HA, stroke, and HTN. Results: A total of 10,937 individuals without diabetes participated in our study. Individuals with a TyG index greater than 8.96 displayed significant increasing in various parameters, including BMI, systolic/diastolic blood pressure, total cholesterol, LDL, and Apo-B levels (p < 0.001). Almost all regression models ensured that a higher TyGI value was associated with higher odds of having CHD, CHF, HA, stroke, and HTN, which patients with a TyGI value higher than 8.96 have odds ratios of 2.24–5.58 for CHD, 1.68–4.42 for stroke, 2.45–3.77 for HA and 1.75–3.93 for HTN comparing than patients with a TyGI value lower than 8.11 (p-value < 0.05).We evaluated the predictive value of the TyG index for each endpoint, obtaining the following area under the curve (AUC) values: 54.75% for CHF (95% CI: 0.542–0.614), 52.32% for stroke (95% CI: 0.529–0.584), 55.67% for HA (95% CI: 0.595–0.646), 55.59% for HTN (95% CI: 0.574–0.597), and 50.31% for CHD (95% CI: 0.592–0.646). Conclusion: The TyG index showed a strong correlation with cardiovascular risk factors in individuals without diabetes, however it was a poor predictor of almost studied cardiovascular diseases.