The present study was conducted to provide future researchers and dental educators with an overview of stress amongst undergraduate dental students reported in the literature. This overview is needed for the development of a new questionnaire measuring the level of stressors including students, staff and process of dental education. In addition, the review can be used to modify dental curricula to decrease such stress and produce better dentists. Our study consisted of a systematic review of 49 peer-reviewed articles published between 1966 till October 2008 in English, discussing different aspects of stress amongst undergraduate dental students. These aspects are demographic variables of stress, sources of stress, impact of stress, indicators of stress, instruments measuring stress level and management of stress. Major sources of reported stress were related to examinations, clinical requirements and dental supervisors. Studies suggest using signs and symptoms for early detection of stress and proper intervention.

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BACKGROUND AND OBJECTIVESThis study is to determine level and factors associated with burnout among physicians in a tertiary hospital in Saudi Arabia.DESIGN AND SETTINGSThis is a cross-sectional study, conducted at the King Fahad National Guard Hospital at in King Abdulaziz Medical City between October 2010 and November 2010.METHODSThe Maslach Burnout Inventory questionnaire was used to measure burnout. Socio-demographic-, specialty-, and work-related characteristics were added to explore factors associated with burnout.RESULTSThe study included 348 participants; 252 (72%) were males, 189 (54%) were consultants, and 159 (46%) were residents. The mean (SD) age was 35 (9.8) years. The burnout prevalence was 243/348 (70%); 136 (56%) of the 243 were residents and 107 (44%) were consultants. Age, female gender, marital status, number of years in practice, sleep deprivation, presence of back pain, and a negative effect of practice on family life were associated with burnout in the univariate logistic regression analysis. The factors independently associated with burnout in the final multivariate model were as follows: suffering from back pain (odds ratio [OR]=2.1, 95%CI 1.2–3.8, P=.01), sleep deprivation (OR=2.2, 95%CI 1.2–3.8, P=.009), being a resident physician/surgeon (OR=4.9, 95%CI 1.7–14.2, P=.004), and negative effect of practice on family life (OR=2.1, 95%CI 1.1–3.9, P=.02).CONCLUSIONIn this study, the prevalence of burnout was found to be higher than estimates documented in most other studies. Reported risk factors should be addressed to decrease the prevalence and consequences of burnout.

Inguinal hernias in infants and young children are a result of a failure of the processus vaginalis to close. 1 Once diagnosed, an inguinal hernia should be promptly repaired on an elective basis to prevent the risk of hernia incarceration. Incarceration occurs in about 12% of infants and young children with an inguinal hernia. The incidence is highest (approaching 30%) among infants (< 1 year old). 2Boys who experience incarceration of an inguinal hernia have a 30% risk of testicular atrophy that may affect future fertility. 3Many countries are struggling with long wait times for elective surgical procedures. [4][5][6] To date, research has been skewed toward examining wait times for surgery and other medical or diagnostic care in adults.7-10 Prolonged wait times for surgery to repair hernias have not been associated with adverse outcomes in adults, 11 but the effect of prolonged wait times in children has not been well studied. 1,12 We conducted this study to examine the relation between wait times for elective surgery and the risk of incarceration of inguinal hernia in infants and young children. We also explored the relation between wait times and the use of emergency department services before surgery. Methods Study population and data sourcesWe used the Ontario Discharge Abstract Database to identify infants and young children who were waiting for surgery to repair an inguinal hernia. This database is maintained by the Canadian Institute for Health Information and contains data on all hospital admissions in Ontario.We included infants and children less than 2 years of age who had a diagnosis of inguinal hernia (International Classification of Diseases [ICD], 9th revision, code 550 or ICD, 10th revision, code K40) and a surgical procedure code for hernia repair (ICD, clinical modification, codes 53.0 to 53.9)

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BACKGROUND AND OBJECTIVESInjury to the head is the most common affected body part in pediatric trauma and could be associated with deleterious consequences. It presents a challenge for developing countries since many injuries are preventable and there are few epidemiological data to support injury prevention programs. The current study aimed to determine demographic characteristics, etiology and outcome of head injury in the pediatric population and compare findings to international figures.DESIGN AND SETINGSRetrospective review of consecutive cases registered in major trauma center database, Riyadh, from 2001 to 2009.PATIENTS AND METHODSThe database registry was limited to hospitalized patients following injury. Any head injury in a patient ≤18 years was included.RESULTSOf 3796 patients identified, 1219 patients (32.1%) suffered head injury (mean age 8.6 years; males 78.4%). Children under 12 years comprised 66.3%. Motor vehicle crash (MVC) was the commonest cause (34.2%), followed by pedestrian injury (30.3%) and falls (28.4%). When stratified by age, falls (45.6%) were the most common etiology under 6 years while MVC was the leading cause in high school students (74.4%). The latter group had the lowest mean (SD) Glascow coma scale scores ( 8.58 [4.7]), highest mean injury severity scale scores (23.4 [21]), highest rate of craniotomy (7%) and highest mortality (20%).CONCLUSIONOne third of pediatric trauma requiring hospital admission suffered head injury. Preschoolers and elementary school students were mostly affected. The striking incidence of pedestrian and fall injuries call for organized national prevention programs. Additionally, more attention should be directed to reduce MVC among high school students given their comparative high rate of severe injuries and deaths following trauma.

SUMMARYAim: To perform a systematic review on the efficacy of intermittent and on-demand therapy with either histamine H 2 -receptor antagonists or proton pump inhibitors for patients with erosive oesophagitis or symptomatic heartburn. Method: We conducted randomized-controlled trials of non-continuous therapy in gastro-oesophageal reflux disease patients. Results: Fourteen studies met inclusion criteria. Because of variation in outcome measures statistical pooling of results was not possible. Results were analysed qualitatively. Four studies evaluated intermittent therapy of treatment 3 days a week with omeprazole 20 mg or daily with ranitidine which were not efficacious compared to a daily proton pump inhibitor. Famotidine 10 and 20 mg, ranitidine 75 mg and cimetidine 200 mg were efficacious in five on-demand studies for relief of symptomatic heartburn episodes. In three of four studies, evaluating only non-erosive (endoscopy-negative) gastro-oesophageal reflux disease patients, esomeprazole 20 and 40 mg and omeprazole 10 and 20 mg a day were efficacious using willingness to continue as an endpoint. Lansoprazole 30 mg and omeprazole 20 mg maintained symptom control in 60-70% of healed oesophagitis patients. Conclusions: Intermittent proton pump inhibitor or H 2 -receptor antagonist therapy is not effective in maintaining control in oesophagitis patients. H 2 -receptor antagonists are effective for relief of heartburn episodes. On-demand proton pump inhibitor therapy may work in a proportion of non-erosive gastrooesophageal reflux disease patients.