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. 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. 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). 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.

Medical students are the category of academic population with the highest levels of stress. This study aimed to assess the prevalence of academic stress among medical students in Saudi Arabia and to identify its associated factors. This cross-sectional study was conducted at the College of Medicine at King Khalid University, Abha. The Medical Student Stressor Questionnaire (MSSQ) was used to evaluate the stress caused by different factors. A total of 422 medical students participated in this study. Among the participants, 115 (27.3%) were male and 307 (72.7%) were female. The highest percentage of students were perceiving moderate to severe stress due to academic-related stressors (97.1%), followed by teaching- and learning-related stressors (93.9%) and group activities-related stressors (88.3%). The lowest domain in which students perceived moderate to severe stress was drive and desire-related stressors (65.8%). The mean percentage of students who perceived moderate-to-severe stress in all domains of stressors was 85.5%. We can conclude that medical students have a high degree of stress, and we emphasize the importance of implementing stress management programs to teach students how to handle stress in order to avoid negative effects on their health and academic performance.

Objectives: The present study analyzed in-hospital first-time stroke mortality in southwestern Saudi Arabia over one-year to assess the in-hospital stroke case fatality rate, mortality rate and explore the factors associated with in-hospital stroke mortality. Study Design: Hospital based follow-up study. Methods: First-time stroke patients admitted to all hospitals in Asser region over one-year period (January through December 2016) were included in the study. Data about personal characteristics, pre-stroke history and clinical criteria, on admission clinical criteria, in-hospital complications and survival status were collected. The last reported Aseer region population was used to calculate age and sex stroke mortality rate per 100,000 population/year. Hazard ratios (HR) and concomitant 95% confidence intervals (95% CI) were computed using multivariate Cox regression survival analysis. Kaplan-Meier curve survival analysis for stroke patients were plotted. Results: A total of 121 in-hospital deaths out of 1249 first-time stroke patients giving an overall case fatality rate (CFR) of 9.7%. Non-significant difference with gender and age were observed in CFR. Overall, in-hospital stroke mortality rate was 5.58 per 100,000/year. Males and elders showed a significantly higher mortality rates. Multivariable Cox regression analyses revealed pre-stroke smoking (HR = 2.36), pre-stroke hypertension (HR = 1.77), post-stroke disturbed consciousness (HR = 6.86), poor mobility (HR = 2.60) and developing pulmonary embolism (HR = 2.63) as significant predictors of in-hospital stroke mortality. Conclusions: In Southwestern Saudi Arabia, the in-hospital stroke mortality rate is higher in men and increases with aging. The prognosis of acute stroke could be improved by smoking cessation, better control of hypertension and prevention of in hospital complication particularly pulmonary embolism.

Recent data regarding first-stroke incidence in Saudi Arabia in general and in the Aseer region in particular are scarce and even lacking. The aim of this work was to study the first-time stroke incidence in the Aseer region, southwestern Saudi Arabia. All first-stroke patients admitted to all hospitals in the Aseer region over a one-year period (January through December 2016) were included. Stroke patients outside the Aseer region were excluded from the study. The incidence per 100,000 patients and the concomitant 95% CI (Confidence Intervals) were computed. The present study included 1249 first-time stroke patients and calculated an overall minimal incidence rate of hospitalized first-time stroke of 57.64 per 100,000 persons per year (95% CI: 57.57–57.70). A steady increase was noticed depending on the patients' age, reaching a figure of 851.81 (95% CI: 849.2–854.5) for those patients aged 70 years and more. Overall, the incidence rate for females (48.14; 95% CI: 48.04–48.24) was lower compared to males (65.52; 95% CI: 65.1–66.0). Taking into consideration the expected rise of the elderly because of the prominent medical services provided by the Saudi government, leading to a subsequent change in the horizontal and vertical age distribution structure of the population, an increase in the number of stroke patients is expected. It is suggested to establish a nationwide stroke surveillance system in the Kingdom, with the objective to report, analyze, and maintain an updated overview of the stroke status in Saudi Arabia.

Contraceptive use as limiters and spacers among women of reproductive age in southwestern, Saudi Arabia