Background: Sleep problems and poor sleep quality are important issues for medical students. This study aimed to investigate the sleep patterns, measure the prevalence of poor sleep quality, and identify the predictors of poor sleep among medical students in King Khalid University (KKU), Saudi Arabia. Methods: This cross-sectional study enrolled 318 medical students during October– November, 2015. Participants were selected by convenience sampling and data were collected using self-administered questionnaires to obtain information regarding socio-demographic variables and indicators of sleep quality. Results: The overall mean sleep quality score was 6.79 with a standard deviation of 3.06. Poor sleep quality was reported by 74.2% students. Significantly high mean sleep quality scores (Pittsburgh Sleep Quality Index) were observed for students with very poor subjective sleep quality (mean = 10.50, SD = 2.58), least sleep efficiency (mean = 11.21, SD = 2.23), shorter sleep duration (mean = 7.83, SD = 2.88), sleep onset latency more than 30 minutes (mean = 7.82, SD = 2.53), sleeping after midnight (mean = 7.53, SD = 2.95), and use of sleep aiding medication (mean = 8.78, SD = 3.5). Significant differences were observed between good sleepers and poor sleepers regarding these sleep characteristics. Poor sleep was predicted by sleep behaviours such as going to sleep after midnight (AOR = 2.18, 95% CI: 1.20, 3.94) and sleep duration of less than seven hours (AOR = 7.49, 95% CI: 4.24, 13.22). Conclusion: Medical students of KKU have poor sleep quality. Longer sleep latency, going to sleep after midnight, and shorter sleep duration are important problems in this group.

Background/Aim: Colorectal carcinoma (CRC) carries a high incidence of morbidity and mortality.Prognosis is related to nodal metastasis and stage. Clusterin is a widely distributed glycoproteinwith not yet fully understood functions. Clusterin may be overexpressed in some tumours or underexpressed in other tumours. The aim behind this study is to examine the relation of clusterincytoplasmic immunostaining to tumour characteristics, disease relapse, and survival in CRC. Materialsand Methods: Paraffin blocks of 133 CRCs were retrieved from the Department of Pathology,King Abdulaziz University, Jeddah, Saudi Arabia. Immunostaining was done using antibody toclusterin. Staining expression in 10% of malignant cells was used as a cut-off to determine lowimmunostaining and high immunostaining. Statistical tests were used to evaluate the association ofclusterin immunostaining with clinicopathological parameters. Results: Immunohistochemical resultsshowed clusterin low immunostaining in CRC and nodal metastases. No association was foundbetween clusterin immunostaining and tumour grade, age, tumour invasiveness, distant metastases,vascular invasion, nodal metastases, relapse, and survival. Conclusion: Our study showed low clusterinimmunostaining in CRC with lack of association with prognostic indicators in CRC. These resultsraise the controversy of understanding the role of clusterin in CRC. Further molecular studies arerequired to explore more about possible mechanisms of clusterin association with tumorigenicity,apoptosis, tumour growth progression, local and vascular invasion, and metastasis of CRC.

PURPOSE: No study had been conducted to assess the hospitals' environment for learning purposes in multicenter sites in Saudi Arabia. It aims to evaluate the environment of hospitals for learning purposes of pediatric residents. METHODS: We applied Postgraduate Hospital Educational Environment Measure (PHEEM) to measure the learning environment at six teaching hospitals in the Eastern Region of Saudi Arabia from September to December 2013. RESULTS: The number of respondents was 104 (86.7%) out of 120 residents and 37 females and 67 male residents have responded. The residents' response scored 100 out of 160 maximum score in rating of PHEEM that showed overall learning environment is favorable for training. There were some items in the social support domain suggesting improvements. There was no significant difference between male and female residents. There was a difference among the participant teaching hospitals (p<0.05). CONCLUSION: The result pointed an overall positive rating. Individual item scores suggested that their social life during residency could be uninspiring. They have the low satisfactory level and they feel racism, and sexual discrimination. Therefore, there is still a room for improvement.
Surveys and Questionnaires ; Discrimination (Psychology) ; Female ; Hospitals, Teaching ; Humans ; Internship and Residency* ; Learning ; Male ; Pediatrics ; Racism ; Saudi Arabia*

A 35-year-old female presented with episodes of frequent dizziness, ear fullness, and right ear tinnitus for 12 months. Head imaging revealed a right glomus tympanicum tumor. She underwent pre-operative endovascular embolization of the glomus tympanicum tumor with surgical, cyanoacrylate-based glue. Immediately after the procedure, she developed drowsiness and severe pain in the right temporal region. Further investigations revealed a right cerebellar stroke in the posterior inferior cerebellar artery territory. She was treated with intravenous heparin, followed by one year of oral anticoagulation. With rehabilitation, she significantly recovered from her post embolization stroke. However, the tumor was resected at another institution. Ten years later, follow-up imaging indicated a gradual increase in the size of the glomus jugulare tumor compressing the nearby critical vascular structures. She subsequently received radiation therapy to treat the residual tumor. Currently, she has no neurological deficit, but her mild dizziness, right ear tinnitus, and hearing impairment persist.

Chronic progressive external ophthalmoplegia (CPEO) is a complex slowly progressive mitochondrial disorder characterized by extraocular muscle weakness with or without multisystem involvement. The mainstay of therapy in a patient with CPEO is supportive. However, in moderate cases, surgery might be indicated including surgeries for ptosis and strabismus. In this article, we report a Saudi patient with CPEO due to compound heterozygous variants in the DNA polymerase gamma (POLG) gene c.2246T>C p.(Phe749Ser) and c.1735C>T p.(Arg579Trp), which are classified as pathogenic. Proper diagnosis with genetic testing confirmation is important to guide the management and counsel the patient about the prognosis and the management options. The patient was successfully managed with bilateral frontalis sling and illustrates the importance of surgical intervention to improve vision and cosmetic appearance in patients with CPEO. We emphasize the importance of multidisciplinary care in the management of cases of mitochondriopathy, especially CPEO.