Objective :  To explore the faculty member’s perceptions and attitudes regarding the faculty development activities. Research Design and Methods :  An online survey that included all staff at the College of Medicine, Qassim University was done.  Data were collected about the academic position, age, gender, academic phase, and the duration of employment at the college; the questions related to the faculty development activities included the level of participation and perceptions about quality and usefulness of these activities were answered. Results: The response rate was 68% (75 out of 110), More than half (56%) of respondents had attended the faculty development activities regularly. For the rest, the reasons for not attending regularly were other commitments (47%) and unsuitable timing of activities (53%); 60 % of respondents thought that attending the faculty development activities should be part of the faculty’s evaluation criteria.  The most favored topics of the faculty development seminars were medical education and research. However, new faculty members had unfavorable comments about the medical education seminars. A majority of respondents preferred workshops as a method of learning. Finally, 91% of respondents thought that the content of the sessions should be posted on the College website.   Conclusion: The medical education and research topics are the most favored by the faculties. Workshops are the most preferred method of learning. Newcomers are less satisfied with the medical education seminars.   Keywords: faculty development, Saudi Arabia.

Background: Visual impairment due to uncorrected refractive error affects 200 - 250 million people in the world.  Uncorrected vision represents the 2 nd or the 3 rd blinding condition in many developing countries. The importance of awareness in dealing with this problem has been shown to reduce the risks of blindness and improve the quality of vision. Methods: Survey questionnaires have been distributed to 2500 randomly selected people from 6 different locations in Riyadh area between late 2003 and early 2004. Only 2039 data sheets (58% female and 42% male) have been analyzed; the remaining 461 data sheets were cancelled whether for biased responses or for ages those were outside the limited range (15-45 years). The questionnaire was designed to show responses according to three levels of education: basic, intermediate and high. Results: 8% of the sample individuals wear spectacle. Of these, 2/3 acknowledges the importance of wearing spectacles. For those who don’t, intellect is a determining factor in how people consider optical correction (21% of basic intellectual backgrounds only think it is important to wear glasses against some 40% of higher intellect). Most of the other results showed the effect of education in increasing the level of awareness in vision related questions. People with higher education are more aware than those with basic intellect in acknowledging: visual symptoms that need care (37% against only 26%), presbyopia condition (23% against 11%), urgency to seek eye care (85% against 29%), factors aggravating refractive errors in children (45% against 29%). Knowledge about the different forms of optical correction showed higher preference for spectacles against both contact lenses and refractive surgery. Conclusion: There is an overall tendency to show that the general public is not aware about most of the problems that concern their visual health. This is even more so in those with basic intellectual levels. In order to reduce the impact of visual problems related to ignorance in society, certain steps directed towards the general public should be undertaken, such as information through media and publicity, public education, screenings for ametropia in schools and at work, government subsidies of optical equipments etc. Keywords: Refractive error, awareness , public, education, visual impairment.

Background: Lead is a metal with many important industrial uses. The relationship between lead exposure and the rise of blood pressure has received a great deal of attention as it was implicated that the mortality from cardiovascular diseases might be reduced by lowering lead levels in the environment . Objectives: The study was to investigate the correlation between the blood lead (B-Pb) levels and the values of blood pressure in hypertensive patients. Moreover, the plasma activities of angiotensin converting enzyme (ACE), plasma levels of nitric oxide (NO), total antioxidants (TAOX) and malondialdehyde (MDA) were estimated to investigate the correlations between the measured parameters and B-Pb levels in hypertensive patients. Methods: Fifty-five hypertensive patients were compared with fifty-three age and sex matched control group. The B-Pb levels were detected by flame atomic absorption spectrometry. The plasma levels of ACE activities, NO, TAOX and MDA were measured by colorimetric methods. Results: In the hypertensive patients, B-Pb levels were significantly higher than controls. Concomitantly, the plasma levels of ACE activities and MDA were significantly increased while the plasma levels of NO and TAOX were significantly reduced in the hypertensive patients in comparison with controls. There were significant positive correlations between B-Pb and each of MDA, and systolic as well as diastolic blood pressure. Conversely, a significant negative correlation was found between B-Pb and NO. Conclusions: Our study indicated that a positive relationship exists between blood pressure and B-Pb levels. The increased B-Pb levels were associated with oxidative stress. Moreover, The B-Pb level was negatively correlated with NO and this may clarify the implication of Pb as leading risk factor for the cardiovascular diseases and hypertension. These findings provide support for continued efforts to reduce lead concentration in the population at Qassim region. Key words : Hypertension, B-Pb, NO, ACE, TAOX, MDA.

Objectives : This cross-sectional study compared the health-related quality of life (HRQoL) of individuals with Buruli ulcer (Focus group) and age-matched apparently healthy peers without the ulcer (Control group) living in Amasaman in the Ga West District, Ghana. Gender pattern in the Health-Related Quality of Life of the Focus group was also investigated. Methodology : Participants comprised of consecutively recruited 84 Focus and 100 Control group subjects. Socio-demographics of all participants and the clinical profile of Focus group subjects were obtained. The Nottingham Health Profile Questionnaire was used to measure the quality of life. Data was analysed using Mann-Whitney U statistic at 0.05 alpha. Results : Focus group had significantly higher scores than Control in all the six (6) domains of the Nottingham Health Profile (p<0.05); no significant difference was observed in the total health score of females compared to males in both the Focus and Control groups (p>0.05). Conclusion : The findings suggest that, Buruli Ulcer impact negatively on the Health-Related Quality of Life of the victims. Aside medical interventions, the quality of life as well as the socio-cultural and economic impacts of Buruli ulcer should be taken in cognizance while planning community-based rehabilitation programmes for those affected. Keywords: Buruli Ulcer; Health-Related; Quality of Life

Objectives: Developing and testing the cognitive skills and abstract thinking of undergraduate medical students are the main objectives of problem based learning. Modified Essay Questions (MEQ) and Multiple Choice Questions (MCQ) may both be designed to test these skills. The objectives of this study were to assess the effectiveness of both forms of questions in testing the different levels of the cognitive skills of undergraduate medical students and to detect any item writing flaws in the questions. Methods: A total of 50 MEQs and 50 MCQs were evaluated. These questions were chosen randomly from various examinations given to different batches of undergraduate medical students taking course MED 411-412 at the Department of Medicine, Qassim University from the years 2005 to 2009. The effectiveness of the questions was determined by two assessors and was defined by the question's ability to measure higher cognitive skills, as determined by modified Bloom's taxonomy, and its quality as determined by the presence of item writing flaws. 'SPSS15' and 'Medcalc' programs were used to tabulate and analyze the data. Results: The percentage of questions testing the level III (problem solving) cognitive skills of the students was 40% for MEQs and 60% for the MCQs; the remaining questions merely assessed the recall and comprehension. No significant difference was found between MEQ and MCQ in relation to the type of questions (recall; comprehension or problem solving x 2 = 5.3, p = 0.07).The agreement between the two assessors was quite high in case of MCQ (kappa=0.609; SE 0.093; 95%CI 0.426 – 0.792) but lower in case of MEQ (kappa=0.195; SE 0.073; 95%CI 0.052 – 0.338). 16% of the MEQs and 12% of the MCQs had item writing flaws. Conclusion: A well constructed MCQ is superior to MEQ in testing the higher cognitive skills of undergraduate medical students in a problem based learning setup. Constructing an MEQ for assessing the cognitive skills of a student is not a simple task and is more frequently associated with item writing flaws.

Objective: To estimate the prevalence of smoking among secondary school students in National Guard area of Riyadh, and explore the reasons for the smoking and the attitude of non-smoker toward smoking habit. Design: A cross-sectional study was conducted in June 2009. By random sampling technique 255 students were enrolled from secondary school of National Guard area, Riyadh, Saudi Arabia.  A self-administered questionnaire was used for data collection. Results: Current smokers represented 28.6% of the students. The most common reasons for smoking were: having free time (81.6%), for the relief of stress (63.2%) and seeing some of their teachers smoking (61.8%). Most of the smokers started the habit before the age of 15 years old (89%). 84% of non-smokers suggested to ban smoking in public places. 42.2% of students were planning to start smoking in future. Religion was the most important reason for not smoking among non smokers. Conclusion: The prevalence of smoking is big enough a problem to be considered as a warning for an impending epidemic Health education provision should have a greater role in schools Governmental commitment and social support are vital if health education and awareness and especially quit smoking programs are to be implemented and sustained. Key Words: Secondary school student, smoking, shisha, magha, Riyadh.

Background: Placebo therapy has always been a subject of controversy in the field of medicine. Some choose to admit it as "fake, irresponsible medicine" while others advocate its effectiveness in various clinical settings. With the advent of the recent concept of mind-body medicine, placebo has entered from fringe to mainstream therapeutics. Some clinicians use it for its actual positive outcomes while others use it merely to buy time until definitive diagnosis or even as a pacifier for patients. Objective: The present study was carried out to observe the perceptions about placebo therapy among health practitioners in Jazan region of Saudi Arabia Methodology: Data was analyzed through statistical analysis of retrospective questionnaires addressing various issues on placebo therapy, including types of placebo used in various clinical settings, mechanism of placebo action, ethics of use and openness with patients etc. Results: The study elucidated that the perceptions regarding placebo therapy are subjective and variable within and between institutions ranging from firm belief in its positive effects and efficacy; to neutral attitudes among some, to strong opposition for it among still others. Conclusion: More research is needed to ethically define the boundary between explicit fraudulence and marginalized evidence based therapeutic deception to effectively achieve the goal of positive health outcomes in patients. Key words: Placebo therapy, Saudi Arabia

Objectives : This study aimed to measure knowledge and attitude of undergraduate medical students towards patient safety concepts, and to detect variation by the mode of learning. Methodology: A cross sectional study administrated an anonymous questionnaire to a random sample of 150 medical students graduated from two national medical schools, one follow the traditional lecture based learning (LBL) and the other applies innovative learning strategy (ILS). Students’ self-ratings of knowledge level and attitude towards patient safety in relation to the mode of learning were measured. The study was conducted in April 2010. Results : More than half of the participants (52.7%) self- rated their general knowledge on patient safety on good level compared to 27.3% for the specific knowledge issues score.  Most participants (60.7%) agreed the importance of patient safety. The majority agreed to support peers who make unintentional errors and not to blame them for their own mistake (76.0 and 80.7% respectively). Less than half (44.7%) of the participants agreed the patients’ role in error prevention and 47.3% agreed error disclosure to the patient. ILS participants were significantly more recognizable of the patient safety issues: problem solving (P< 0.01 OR: 3.0) and error management (P< 0.001 OR: 2.4) than the ILS colleagues. Conclusion : The study revealed unsatisfied percentages of the participants who self- rated ‘good’ for their general and specific knowledge on patient safety. The unsatisfied rate was reported for the participants’ ‘agree’ score towards patient safety issues. Basic relevant educational interventions with focus on deficient issues are recommended. Key words : Patient safety, Medical errors, Medical students, Saudi Arabia

Background and objective : With the advent of laparoscopy into pediatric surgical filed and with experience gaining, as well as, improvement in instrumentation, it has been used in management of different conditions, including intussusception. However, there is no universal acceptance regarding its role in reduction of intussusception. This is due to the early reports of high conversion rate and the concern of missing a lead point. The aim of this article is to review the literatures about safety and efficacy of laparoscopy in intussusception management and the limitations as well as formulating a working algorithm for management of intussusceptions in pediatric age group up to 18 years. Up to my knowledge this is the first review article in this subject. Method : A comprehensive review of the English literature in Pub Med searching engine was conducted with key words laparoscopy, intussusception, management of intussusception, minimal invasive surgery and intussusception, laparoscopic reduction of intussusception, between 1996 and2009 .The results yielded were further explored for citation regarding the role of laparoscopy in reduction of intussusception. Results : The success rate increased from 57% in 1997 to 91% in 2009 while the conversion rate decreased from 43% in 1997 to 9% in 2009.The presence of a lead point and/or ischemic bowel were the main reasons for conversion in the initial reports. Conclusion : Laparoscopy is a safe and efficient method for reduction of intussusception.The presence of a lead point or necrotic bowel is no more indication for conversion to open surgery. Laparoscopy should be an integral tool in the management algorithm of intussusception. Keywords : intussusception reduction, laparoscopy in children, role of laparoscopy in intussusception.

Objective : To report on two cases of neurobrucellosis with different presentations. Method : Retrospective report of the data on 2 cases of neurobrucellosis: the first case presented with acute meningo-encephalitis and the second case presented with acute meningitis. Result: Both cases had indolent fever for more than a month. The first case presented acutely with a diffuse maculopapular rash all over the body for 1 day prior to admission and a sudden deterioration of the level of consciousness, weakness, and generalized tonic-clonic convulsions lasting for 2 minutes.  The history of the presenting illness indicated a strong history of contact with animals and animal products. The second case was presented to our hospital with history of fever on and off for 2 months and 1-day history of headache and neck pain, but no history of vomiting, convulsion, or loss of consciousness. Both cases were diagnosed by the serum agglutination test and cerebrospinal fluid Brucella culture. Both cases were treated for 6 months with combination therapy of anti- Brucella drugs with excellent outcome. Conclusion : These are rare and serious presentations of this common public health problem, unless the physician has a high index of suspicion, morbidity and mortality will not be prevented.  So, the description of both cases and a brief review of the current pediatric literature are provided to familiarize pediatricians with the relatively rare presentations of this common worldwide disease.

World Health Organization (WHO)  defines ‘disaster’ as, “a serious disruption of the functioning of a community or a society causing widespread human, material, economic or environmental losses which exceed the ability of the affected community or society to cope using its own resources.†‎ 1 ) Natural disasters are a fact of life. We can neither escape nor can we avoid them. We could, however, reduce or prevent the resulting damage. Ironically, human beings have added their own dimension, called man-made disasters, to them. In the past five years or so, natural disasters have consumed hundreds and thousands of lives. Many cities and towns where once life went on at its full pace have been devastated beyond recognition or have simply been obliterated. Japan is a case in point. Haiti, Southern Australia and Christchurch are some more examples of the human frailty against the wrath of nature. (2) The scale of the damage caused and the looming threat have made the national and international communities to come up with or at least think of an organized response. Many governments and UN agencies have launched a range of initiatives to cope with disasters. The events of the last five years have sent disaster management planners around the world back to the drawing boards. Countries are rethinking their disaster management strategies. The ensuing situation calls for a serious review of our disaster management plans for the Kingdom and indeed for the whole of Middle East. There is no denying the fact that disaster management is a multi-sectoral and an interdisciplinary subject. All participating departments and ministries have their respective and collaborative roles. However, I would like to focus on the envisioned role of the academia and the health sector. I am using the term academia because it is all embracing and cuts across the public and private sectors, and other bureaucratic boundaries. Generally, Middle East does not have a strong tradition of ‘think tanks’ that continuously research current and future issues and pave the way for future strategies by generating knowledge and information. I would like to propose the formation of think tanks as their research is independent and dispassionate. Hence, the knowledge they generate and manage has a professional merit, is unbiased and is not influenced by vested interests. (3) Results of their research drive the decision support mechanisms in both public and private sectors by providing a rational and solid basis for strategies. We do not have much time to wait! The academia in the Middle East needs to put its act together and lay the foundation of this intellectual discourse. Disaster management should be taken up as one of the priority subjects. The knowledge generated would then inform the disaster management strategies not only in Middle East, but across the world. The second issue I would like to highlight is the strategic role of health professionals in disaster management. Traditionally, Ministries of Interior or their implementing arm the General Directorate of Civil Defense (as in Saudi Arabia ‎ 4) are the focal point for coordinating and leading disaster management plans, which makes a lot of sense, as they have to liaise with a number of governmental and non-governmental organizations. They are the best placed to do so. However, I would emphasize the importance of allowing a more strategic role for health professionals, both the public and private sectors, in disaster management planning. Ministry of Health, with the participation of private health sector, is best suited to take this role. ( 5 ) Perhaps the first step is an internal review of the entire health sector to evaluate preparedness and response capacity of the health facilities in the unfortunate event of a disaster. Central to this review should be a series of robust stress tests to evaluate the preparedness and response capacity of the health sector to hypothetical disasters. Stress tests could be worked out by developing different scenarios based on the last ten years data on natural and man-made disasters. Questions such as, can a particular city or town cope with a 100 injured people? Does it have sufficient logistics? Does it have a database of blood donors? How can it mobilize resources and logistics? Do health professionals have the required level of training? And above all, ‘who will be the focal point to coordinate the various bits and pieces in the unfortunate event of an emergency? The results accrued from the stress tests would give us a base line to work on. Comparing it with the required level would identify gaps. Filling up the gaps would give us a reasonable level of disaster preparedness and appropriate response capacity. Of course, this is a conceptual framework that I have proposed. The actual exercise will have to be planned in much more detail. We may not have all the answers to these vital questions but the corrective work could be initiated once we have completed the stress tests. I would encourage researchers, without making any distinction between the health and non-health, to think about their role in disasters. I would be happy to offer the pages of International Journal of Health Sciences for publication of any research that adds value to the current body knowledge on disaster management.