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From ZERO To RCT

From ZERO To RCT. Abdulelah Nuqali Mohammed Badawi Omar Taibah. The Aim. 5 Years Ago.. When I was in 2 nd year of medical school. Newspapers. 5 Years Ago.. When I was in 2 nd year of medical school. Our professors CVs. 5 Years Ago.. When I was in 2 nd year of medical school.

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From ZERO To RCT

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  1. From ZERO To RCT Abdulelah Nuqali Mohammed Badawi Omar Taibah

  2. The Aim

  3. 5 Years Ago.. When I was in 2nd year of medical school • Newspapers

  4. 5 Years Ago.. When I was in 2nd year of medical school • Our professors CVs

  5. 5 Years Ago.. When I was in 2nd year of medical school • Prevalence studies

  6. 5 Years Ago.. When I was in 2nd year of medical school • Students Achievements

  7. .. 3rd Year Medical Student

  8. 4th Year Medical Student • Community Medicine

  9. Assemble a research team • 10 members + 1 supervisor • + 1 advisor Hints: < 5 authors, unless you have a big project Who are the authors? Role allocation

  10. Choosing a Research Question • Difficult Vs. Easy • Smoking among Medical Students at Umm Al-Qura University

  11. After a Literature Review • The Trend of Smoking Habit through Academic Years among Medical Students at Umm Al-Qura University (UQU) (2010)

  12. Continue a Research Process

  13. Abstract • Marketing your research

  14. Research Presentation at Conferences • Poster Vs Oral presentation • 3rd Medical Students Research Day, King Abdulaziz University • The preparatory scientific meeting of Umm Al-Qura University Students for the 2nd scientific conference

  15. Publication • Reasons for rejection of our manuscript: • A lot of authors • The topic was not interesting • Female gender was not included

  16. Research 2 Mohammed I. Badawi

  17. Elements needed • Research Idea • Supervisor • Research team • Approval • Statistician

  18. Research Idea • New • Feasible • Achievable • Short time

  19. Psychiatry! • Suggested research idea: Depression and Anxiety among Chronic rheumatological diseases Patients in Makkah, Saudi Arabia • Modified research Idea: Depression and Anxiety among Dialysis Patients in Makkah, Saudi Arabia

  20. Issues • How can we diagnose depression or anxiety? HADS • Translation:

  21. Issues 2. Approval.

  22. Data Collection • Hospital system • Time (Al hajj vocation for ourselves and patients-personal commitments- far)

  23. What is next? • Poster • Publication

  24. Depression and Anxiety among Dialysis Patients in Makkah, Saudi Arabia Authors:Dr.MohammedBadawi, Dr. Omar Taibah, Dr.AbdulelahNuqali, Dr. Omar Alserihy, Dr. MuaidMorad, Dr. EmadKalantan, Dr. Ibrahim Turkistani, Prof. Sirag Al Rady Introduction Results The WHO estimates that during the early portions of the 21st century depression will be the second most common debilitating illness worldwide . Depression has been thought to be the most common psychiatric abnormality in End-stage renal disease (ESRD) patients. A study reported that over 70% of patients on maintenance hemodialysis (HD) who had symptoms of depression or anxiety and described barriers to mental health treatment, did not recognize their symptoms or did not perceive that they were in need of therapy for their mental health condition,. Drayerand colleagues found that patients with ESRD and depression have 4.1 times the mortality rate of patients with ESRD who do not have depression . Another study suggested a higher rate of withdrawal from maintenance dialysis in patients who developed depression while on dialysis than in those patients who were not depressed. These investigators also found a higher risk of mortality and hospitalization associated with depression. Of 286 ESRD patients on hemodialysis 58.2% were males. The dominant age group is above 40. Only 32(11.3) were diagnosed with depression or anxiety before the onset of the ESRD, and overall 20(7%) patients were currently on depression or anxiety medication. 57(21.1%) patients diagnosed with anxiety and 63(23.3) subjects were suffering of depression based on HADS. Table 2. Anxiety Scores with Different Variables Table 3. Depression Scores with Different Variables Objectives: Primary: to find out the prevalence of depression and anxiety among Saudi dialysis patient in makkah. Secondary: to find out the relationship between duration of HD and increase incidence of depression. Conclusion Anxiety and depressive symptoms are not uncommon among ESRD patients in Makkah. Early detection and management can improve clinical outcomes. Methods A cross-sectional study of anxiety and depression in (ESRD) Saudi patients in Makkah, conducted during November 2011. The subject’s physical, social and environmental health status were assessed by an interview. The Hospital Anxiety and Depression Scale (HADS) was used to screen for anxiety and depression. Our study included a sample size of 286 outpatients on maintenance HD from dialysis centers in Makkah, two main centers Al-Noor and Al-Zahir hospitals. The consent was taken orally. All patients were included in the study. Exclusion criteria were non Saudi patients, patients who refuse to fill the questionnaire and patient with communication barriers. The HADS is one of the most popular self-reporting tool for measuring depressive and anxiety symptoms. Even though the HADS questionnaire is a self-assessment scale, all patients were interviewed by a research member to full fill it. For data management and statistical analysis, SPSS 12.0.1. was used and P value < 0.05 was considered statistically significant. References Ustun TB, Ayuso-Mateos JL, Chatterji S, Mathers C, Murray CJ: Global burden of depressive disorders in the year 2000. Br J Psychiatry 184:386–392, 2004 Kimmel PL: Psychosocial factors in dialysis patients. Kidney Int 59:1599– 1613, 2001 Finkelstein FO, Finkelstein SH: Depression in chronic dialysis patients: assessment and treatment. Nephrol Dial Transplant 15:1911–1913, 2000 Kimmel PL: Depression in patients with chronic renal disease: what we know and what we need to know. J Psychom Res 53:951–956, 2002 Levy NB. What is psychonephrology? J Nephrol. 2008;21 Suppl 13:S51-3. Drayer RA, Piraino B, Reynolds CF, 3rd, et al. Characteristics of depression in hemodialysis patients: symptoms, quality of life and mortality risk. Gen Hosp Psychiatry. 2006;28:306-12. Lopes AA, Bragg J, Young E, et al. Depression as a predictor of mortality and hospitalization among hemodialysis patients in the United States and Europe. Kidney Int. 2002;62:199-207.

  25. Take home message Do not lose hope. Have a clear goal. Be ready. You can do it.

  26. Randomized controlLed trial Omar S. Taibah Research 3

  27. A Dream .. • Moving from knowing to changing! • A research in each subject!

  28. We needed a mentor.

  29. Choosing a topic.

  30. We had no experience at all. • First RCT from UQU?

  31. What is next? • Proposal: • Our goal. • Literature review. • Biostatics. • Protocol.

  32. What is next? • Ethical approval: • Long process. • It took more than six months. • Enthusiasm only takes you this far.

  33. WE GOT THE ETHICAL APPROVAL!

  34. Are we there yet? • We need money! • Getting grant: • An even longer process. • New proposal! • Lots of paper work (consents, Arabic versions, detailed budget, referees, etc..). • Hope could have been easily lost.

  35. WE

  36. WE GOT

  37. WE GOT 133,000 SR!

  38. Recruiting: • Verbal agreement with hospitals. • Ongoing. • Presentation skills.

  39. Future tasks.. • Data collection. • Data entry. • Results. • Publication.

  40. Are we there yet? • NO! we are not even close!

  41. What we got so far.. • Experience. • Knowledge. • HOPE!

  42. What I’m saying is .. • If we can go this far, YOU can go further!!

  43. Questions?

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