Rukshini Puvanendran is a consultant in the family medicine service at the KK women and children’s Hospital in Singapore. She runs the menopause andbosteoporosisi services of the hospital. She is also assistant professor in Family medicine at the Duke NUS Medical School.

Introduction:Osteoporosis Patient Targeted and Integrated Management for Active Living (OPTIMAL) is a fracture prevention program instituted in the public hospitals in Singapore since 2008 (2). The program included patients over 50 years of age with osteoporosis. The program constituted an osteoporosis education, falls assessment, falls prevention exercises and pharmacotherapy. Additionally case mangers followed up the patients with six follow up encounters over 2 years. We report on the outcome of the program. METHODS:Patients were interviewed by an investigator (not the assigned case manager) and falls, fracture and compliance to medication and exercise was evaluated. Compliance to medication was assessed by the medication possession ratio and verified via patient interview. RESULTS:101 patients were recruited based on WHO Fracture Risk Assessment Tool (FRAX) for primary fracture prevention . 95 patients had completed a 2-year follow-up at the hospital and were evaluated as part of this study. 77.89% of the patients reported compliance to medication. The commonest reasons for non adherence to treatment are not seeing the importance of medication and fear of side effects. CONCLUSION:Our report suggests that a fracture prevention program with structured education and case management can be effective in improving treatment rates.

Sultan Saleh has been graduated from King Abdulaziz University as Medical Doctor May 2016. A Founding member of “Student Research and Innovation Unit” in association with Deanship of Graduate Studies and Research in Faculty of Medicine, King Abdulaziz University. 1st place as best student prepared presentation in Radiology rotation 2014. I have the passion for doing research. I have also been appointed leader of several projects. For further information about me, I would be glad to send my resume.

Completeness of medical record is essential as deficiencies could pose risk to patients’ health. Interns/residents who do the admission clerking are therefore expected to take a detailed history and perform a thorough physical examination to all patients at admission. We are questioning the completeness of their notes according to what they had been taught as students. A retrospective study of 860 patients who were admitted during two months from 1st of December 2014 to 31st of January 2015. Admission notes were reviewed through the electronic medical record health information system and were evaluated using a checklist structured using the referenced textbooks for medical students. The data were summarized into frequency and relative frequency. Average informativeness index was calculated using Guilbert’s equation.The overall average informativeness index was 50%, which is unsatisfactory. In the history taking part of the survey, In the history taking part of the checklist, notes of “associated symptoms” were the most informative (82.4%) while previous episodes, family history, medication and allergies were informative in 5.6%, 2.9%, 4.8% and 1.9% of the notes, respectively. The physical examination part shows an overall extreme lack of informativeness especially breast examination that wasn’t documented informatively in any of the notes. This retrospective study delineated that the standards are not completely followed by interns/residents. Future research should be conducted regarding the reasons as an attempt to solve this issue.

Reem M. Basalasel has been graduated from the Collage of Medicine, King Saud University, Riyadh (Saudi Arabia ) as Medical Intern, with the speciality general medicine and surgery. She was born in Riyadh, Saudi Arabia on 14 July 1992, Reem is expected to complete her training program at King Saud University on 30 June 2017. She is working towards becoming an internal medicine physician.

Background:Twitter as other social networking sites (SMS) is a virtual community where users can create and share many things. Nowadays we see many medical students of all year use Twitter as a way to entertain and minimize their college stress. However, spending a huge amount of time in using Twitter can lead to addiction that may extend to psychological and health problems. Objectives:This study aimed to evaluate the prevalence of Twitter addiction among undergraduate King Saud University medical students in Riyadh and to determine the relationship between Twitter addiction and personality traits. Methodology:The study population is all medical students in the college of medicine, both genders with sample size of 165. It was conducted from 12t to 19th of April 2014. The study design is quantitative (observational) cross sectional. We emailed the questionnaire to all students in the college. Study setting: King Saud University, Collage of medicine, Riyadh, Saudi Arabia. Result:The results show that the prevalence of twitter addiction among medical students in both genders is high. The percentage of addiction among male was 93.7 %. While in female was 92.3%. Also, there were no any significant correlations between twitter addiction and personality traits in males. While in female, neuroticism was negatively correlated to twitter addiction. Conclusion:The prevalence of twitter addiction in medical students is high, indicating a problem that needs to be solved.

Mohammed Ahmed alhomrani, has been Graduated from Prince Sattam Bin Abdulaziz University as Medical Doctor, with MBBS degree in 2016,and now is now working as a routing intern in Riyadh , Saudi Arabia

Introduction: Body mass index (BMI) has been shown to be related to many aspects of the general health of the individual and affecting multiple body systems, Such as increasing the risk of coronary heart disease, diabetes, hypertension and recurrent kidney stones. Urinary tract infection (UTI) is considered one of the most common infections, affecting specially women more than men. Unfortunately, research data linking BMI to the increased risk of UTI are few. Objectives: The aim of this study is to evaluate the relation between Body Mass Index (BMI) and UTI in Female patients attending the outpatient’s clinic in Prince Sultan Bin Abdulaiziz University Hospital (PSAUH) in AL-Kharj, Saudi Arabia. Methodology: This is a hospital -based cross sectional study in which information was collected using patients’ records of Prince Sattam Bin Abdulaiziz University Hospital (PSAUH) in Al-Kharj Saudi Arabia. The data of all Female patients diagnosed with UTI, including socio-demographic information’s, weight, high and all the relevant clinical data was collected and then analyzed using Statistical Package for the Social Sciences (SPSS). Results: Out of a 192 patients diagnosed with UTI, (41.7%) were found to be an overweight. There was a significant relation between obesity (BMI ≥30) and urinary tract infection (p value: 0.0005) with 62 obese patients having infections compared to 28 patients who were normal or underweight. Conclusion: Our results show a significant correlation between body weight and urinary tract infections. More prospective studies on larger cohort of patients are needed to validate our results.

Abdullah Alharbi has been Graduated from Collage of Medicine, Prince Sattam Bin Abdulaziz Universitiy, 2016 as a Medical Doctor. Presently he has been working at the Prince Sultan Militry Medical Center as an intern in the General Surgery department.

Introduction: The management of diabetic foot becomes more difficult due to increase the number of complications related to bacterial infections leading to ulcerations and necrosis stages, which require aggresive treatment often with necessity of lower limb amputations. The aim of this study was to analyse the bacterial spreading and outcomes of treatment of 81 diabetic patients with infected necrotic foot lesions. Methods: The bacteriological analysis of exudate from wounds, distal and proximal segments of the tendons removed during surgical debridement or amputation were conducted in all patients. Microbiological investigations demonstrated that the contents of anaerobic bacterial flora in a wound and in the distal end of tendons were almost identical. Results: In the proximal end of tendons the gradient of aerobic bacteria was 2,8+/-0,19 Lg/g, while for representatives of anaerobes it was less expressed 1,71+/-0,16 Lg/g (p < 0,01). Analysis of microbial spreading revealed the growth of bacteria in all cases. In 89,9 % of the cases the associations of aerobes with anaerobes were found. Pr. Melaninogenicus was dominating agent among anaerobes (34,5%) leading in the development of an infectious process and distributed in a proximal direction along synovial-tendon sheaths of the foot. Conclusion: Aggressive debridement of necrotised tissues, including proximal and distal parts of tendons up to 7 cm within the limits of healthy looking tissues may disrupt further spreading of purulent infection and lead to a more favorable outcome.

Sara Aldokhayel, Leena Zeitouni and Layan Al Tawil are medical students attending King Saud University in Riyadh, Saudi Arabia. A leading Arab university of medicine and research. Graduated from prime high-schools in the capital of Saudi Arabia. Currently in our fourth year, rotating in King Khaled University Hospital. A highly reputable hospital in the Middle East.We are all merit students with high cumulative GPAs. We have attended several local research-related courses and are actively involved in the research community.

Objectives:To determine and compare the prevalence of (CVS) symptoms and its associated factors among female students of Medicine and Business colleges at (KSU). The study also aims to measure the knowledge of the students in preventing (CVS) symptoms. Methods:A total of 713 female students in Medicine and Business Colleges in (KSU) were recruited for a quantitative cross-sectional study. A self-designed structured questionnaire was used to ask about CVS validated symptoms (headache, neck and shoulder pain, dry eyes, burning eye sensation, eye redness, and blurred vision) and variables contributing to CVS development. Results :Majority of the self-reported symptoms were in the mild category in which headache was the most prevalent (42.1%). The most prevalent severe symptoms were neck and shoulder pain (11.8%) and dry eyes (5.6%). Being a business student (odds ratio: 1.65; 95% CI:1.22-2.24) and using devices for more than 5 hours (odds ratio 1.52; 95% CI: 1.07-2.16) were significantly associated with developing CVS symptoms. Comparison of symptoms between business and medical students showed significantly higher prevalence in business students for all symptoms except burning eye sensation, which was higher in medicine (p posture, lighting of room, screen brightness, and distance from screen were found to be associated with occurrence of CVS symptoms.

Lee Heui-yung has been Graduated from Dong-Kuk medical university, as Family medicine Doctor, with the resident. Presently he has been working at Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Background: Despite the majority of upper respiratory infections being viral, a high percentage of patients are treated with antibiotics, even though many drugs are not needed. The objective of this study is to find ways to reduce drug abuse for upper respiratory tract infection, patients by comparing practice patterns according to a physician’s position. Methods: We analyzed the diagnostic tests and utilization pattern of medications prescribed for upper respiratory tract infections (URIs) in outpatient settings. We reviewed medical records of the patients diagnosed with upper respiratory tract infections and being seen in the outpatient clinics of the Department of Family Medicine of Asan Medical Center (AMC) from March 2013 to December 2013. The percentage of laboratory tests, a chest X-ray, and medications prescribed and the proportion of the number of medications was calculated. Results: Of the 259 URI episodes identified, professors and fellows tended to use more chest X-rays than did residents and residents and fellows made more use of NSAIDS, antitussives, mucolytics and antihistamines than the professors did. Antibiotics were prescribed in 13.5% of all URI episodes and there were no significant differences between the physicians. Conclusions: We reviewed practice patterns regarding URI patients, according to a physician’s position in a university hospital based family medicine practice. Professors and fellows tended to use more chest X-rays than did residents. Residents and fellows made more use medications than the professors did.

Etab Yagoub Musa has an honorary degree in medical, surgical nursing from university of Khartoum, she have master degree in medical, surgical nursing also from university of Khartoum and now she is a PhD student in the university of Khartoum, she is a member in Sudanese islamic medical association and member in professional specialized foundation of nursing and she is a lecturer (teacher) in university of Khartoum since 2012, she attend one conference in Ainshams university in Egypt, she participated in three conferences inside the Sudan.

Peripheral intravenous cannulation is one of the most common procedures done at the hospital every day since most of drug administration depends on intravenous route. This study conducted to assess nurse’s knowledge and practice toward peripheral intravenous cannulation in Alribat university hospital. The objectives of the study are to assess nurse’s knowledge toward peripheral intravenous cannulation, and to determine nurse’s practice toward peripheral intravenous cannulation. The result of the study is the nurses have good knowledge regarding the disinfectant used, methods and technique encourage vein to appear, solution used to flush the cannula, but have poor knowledge regarding the causes and signs of complications and how to choose the appropriate site for cannula insertion .and, 68% of the sample applying the procedure of calculation properly. The following is recommended: The researcher found that differences in knowledge and practices between the study sample mean that there is no one policy for the calculation so the universal policy should be done by hospitals or ministry of health ,the supplies should be available . Finally work shop needed to give the nurses the exact policy for intravenous cannulation as a serious and common procedure.

Sarah alsenidi is a medical student at King Saud university, college of medicine.

Background:Recent studies had shown that sepsis still represents a major health problem worldwide. Moreover, it is resulting in significant morbidities and mortalities among children. Research Methodology:This is a retrospective quantitative observational study of the medical records, PICU database, and the hospital electronic system for integrated health information (E-Sihi) for pediatric patients admitted to PICU at KKUH, KSU with sepsis during from January 2014 till March 2016. Demographic, clinical, laboratory, and outcome data were collected in a predesigned sheet. The inclusion criteria were, any pediatric patient (age less than 14 years old) admitted to the PICU with sepsis and/or septic shock. Collected data were statistically analyzed using SPSS. Results:Forty-seven patients, representing 4.2% of the total admissions to the PICU at KKUH during the study period, were included in the study. They were 23 males and 24 females and their median age was 5.7 months. Four patients (8.5%) were immunocompromised, and respiratory tract infection was the most common septic focus (14, %). Mortality was more in patients with; positive fluid balance (655.7 versus 236.3 with p value 0.02), hypotension (61.5% versus 29.4 with p value 0.054), hypoxia (30.8% versus 2.9% with p value 0.017), high blood lactate (53.8% versus 17.6% with p value 0.026), and mechanical ventilation (84.6% versus 55.9% with p value 0.094). No significant differences were found in relation to the rest of studied variables. Conclusion:Sepsis still represents a significant cause of mortality among children admitted to Pediatric Intensive Care Units. Initial presentation with hypotension, hypoxia, the need for mechanical ventilation, positive fluid balance at 24 hours from admission, and high initial blood lactate seem to be risk factors for mortality among such patients.

Noura Ahmed is a fourth year medical student at King Saud University. Her interests include campaigns against domestic violence and women's rights.

Objectives:To quantify the prevalence and associated factors of domestic violence, the attitude levels towards domestic violence, and observe the association between domestic violence and attitude level among female KSU medical students and female outpatients at KKUH. Methods:It’s an observational, quantitative, cross-sectional study conducted on females aged 15-65 years attending KKUH outpatient clinics and KSU medical college students with a sample size of 513 women. Convenience sampling was used to select the study subjects. A self-administered questionnaire was distributed and it included socio-demographic characteristics, HITS tool for screening of domestic violence, and Attitude Towards Domestic Violence Questionnaire to measure attitude levels towards domestic violence. SPSS PC+ V21.0 statistical software was used to analyze the data. Result:A total of 513 women, 327 medical students and 186 out-patients, has participated in the study. Thirty one woman (6%) admitted to being affected by domestic violence. 209 women (40.7%) were found to be more accepting of domestic violence. 21 of those accepting domestic violence (10%) were victims of domestic abuse. Significant association between the presence of domestic violence and accepting domestic violence was observed. Conclusion:The prevalence of domestic violence among our subjects was less than expected when compared to the global prevalence, but similar to previous studies done in Riyadh, Saudi Arabia. The odds of being affected by domestic violence were more in those accepting domestic violence, based on their attitude score towards domestic violence.

Jana Jamal Saad Alkishi has been graduated from high school 2011 and presently she is a 6th Year Medical Student at King Abdulaziz university, Saudi Arabia

Introduction: Patient satisfaction is an evaluation of health care as to whether or not expectations have been met (Palmer and Donabedian, 1991) (1). In the early 2000’s, some researchers started to conduct studies about patient attitude and satisfaction in primary health care services, then in hospitals (2). Patient satisfaction or dissatisfaction in KAMC-Jeddah were not documented before. Aim Exploration of patient satisfaction in KAMC-Jeddah in order to improve the quality of healthcare. Objective: To assess the level of patient satisfaction in different aspects of health care service in KAMC-Jeddah Method: A cross sectional study was conducted between July 29th - August 4th 2016 at KAMC –Jeddah. Face to face interview survey method was used. The total study population was 283. Patients who were 18 years or above, mentally competent, with file and had been served by the hospital for at least 6 months were included. Two different questionnaires were used. The questionnaires were validated among a pilot group of twelve patients. The reliability of the questionnaires was measured by alpha coefficient 0.85 and 0.86 respectively. The data was coded by SPSS version 20. Limitations: - In ER department, Patient satisfaction was not measured due to administrative constrains. - In Cardiac center, there was no sufficient patients to represent the level of satisfaction. Conclusion: Emphasis on patient satisfaction with medical care services is growing. The result of this study will support policy and decision makers to come up with new strategies that incorporate the patient centered care and increase the efficiency of quality care to reach international standards.

Mohammed Abdulrahman Hussain is a Student of King Abdulaziz University, Saudi Arabia.

Background: (MRSA) is a known organism to clone the anterior nares of normal individuals. Medical students are at a higher risk of developing MRSA during their training program as they are in contact with patients and spreading it to susceptible hosts. There is a limited knowledge about the prevalence of S.Aureus and MRSA among medical students in KSA. Objective: To determine the MRSA colonization rate in medical students at KAUH located in Jeddah, KSA between their basic and clinical years before and after they come in contact with patients. Methods: This cross sectional study screened nasal swabs which were taken from medical students randomly for S.Aureus using the standard microbiological methods set place in the Microbiology lab of King Abdulaziz University hospital. Results: Among 504 participants, nasal carriage of Staphylococcus species was detected in 31 (15.20%) preclinical students and 31 (10.33%) clinical students. Other staphylococcus species (non Aureus) were found in 2 (0.98%) preclinical students and in 13 (4.33%) clinical students. The nasal colonization was positive to S.Aureus in 29 (14.22%) of the preclinical students and 18 (6%) of the clinical students. The culture and sensitivity also showed that the S.Aureus was resistant to penicillin in 27 (13.24%) of the preclinical students and 27 (9%) of the clinical students. Conclusion: in this study, there was no significant association between exposure to the hospital environment and S.Aureus nasal colonization.

Completeness of medical record is essential as deficiencies could pose risk to patients’ health. Interns/residents who do the admission clerking are therefore expected to take a detailed history and perform a thorough physical examination to all patients at admission. We are questioning the completeness of their notes according to what they had been taught as students. A retrospective study of 860 patients who were admitted during two months from 1st of December 2014 to 31st of January 2015. Admission notes were reviewed through the electronic medical record health information system and were evaluated using a checklist structured using the referenced textbooks for medical students. The data were summarized into frequency and relative frequency. Average informativeness index was calculated using Guilbert’s equation. The overall average informativeness index was 50%, which is unsatisfactory. In the history taking part of the survey, In the history taking part of the checklist, notes of “associated symptoms” were the most informative (82.4%) while previous episodes, family history, medication and allergies were informative in 5.6%, 2.9%, 4.8% and 1.9% of the notes, respectively. The physical examination part shows an overall extreme lack of informativeness especially breast examination that wasn’t documented informatively in any of the notes. This retrospective study delineated that the standards are not completely followed by interns/residents. Future research should be conducted regarding the reasons as an attempt to solve this issue.

Mohammed started his undergraduate medical school program for which he was focusing on balancing between satisfying the course requirements and gaining hospital training. In addition, he participated in many researches with different specialties such as pediatric, medical education, nutrition. Mohammed is a medical intern who is working towards becoming a pediatrician, and he is going to graduate from King Abdulaziz University in 2017

Omar Alsultan has been graduated from Dammam University. Now he is working as intern in King Abdulaziz Medical City Hospital.

Background: The values of electrolytes are measured by both the arterial blood gas analyzer and the auto-analyzers, in arterial and venous blood respectively. Literature reports suggest controversies in comparisons between the results. Concerns have been increased about the precision of the instrument due to differences in results of laboratories, in addition to the time consumed. Materials and Methods: This is a prospective observational study of serum and ABG electrolytes on samples from 53 (34 Male and 19 Female) patients admitted to ICU at King Abdul-Aziz Medical City (KAMC). The analysis was done in Central Laboratory. The results from patients’ file were uploaded to SPSS from excel sheets and statistical analysis was done. Results and Conclusion: The age of patients varied between 14 years and 87 years in both the sexes. The sex wise frequency was 64.151% (males) and 35.85% (females). The pathological reports showed the highest incidence of post-Motor Vehicle Accidents (MVA) followed by Community Acquired Pneumonia (CAP) and Respiratory Failure (RF). Comorbidities were infrequent. However; the highest incidence was related to Diabetes (DM) + Hypertension (HTN), followed by HTN alone and subsequently DM alone. SPSS analysis showed a correlation between serum electrolytes and ABG electrolytes was significant at 0.01 levels. Correlation between serum and arterial electrolytes was significant, however; related to the time it was weakly negative. We conclude that critical decisions can be made by trusting the values obtained through both ABG and Serum levels of the electrolytes.