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.