Objectives: To estimate the pre-hospital delay time among patients diagnosed with acute myocardial infarction and to determine factors associated with prehospital delay. Methods: A cross-sectional study was conducted among 200 patients with myocardial infarction at Madinah Cardiac Center, Al Madinah Al Munawarah, Saudi Arabia between November 2019 and March 2020. Data were collected by direct physician-subject interviews. We used the validated version of the modified response to symptoms questionnaire. Chi-square test, t test, Original Article and multivariate analysis were used to examine factors associated with pre-hospital delay. Results: The median pre-hospital delay time was 3.7 hours. Among all the patients, 126 patients (63%) arrived at the hospital later than 2 hours from the onset of symptoms. Factors that were significantly associated with pre-hospital delay included a previous information on acute coronary syndrome (adjusted odds ratio [adj OR]=0.35, 95% confidence interval [CI] 0.1-0.6), history of hypercholesteremia (adj OR=2.3, 95% CI 1.1-4.7), arrived by ambulance (adj OR=0.3, 95% CI 0.1-0.8), and increased pain intensity (adj OR=0.7, 95% CI 0.6-0.9). Conclusion: Approximately two-thirds of the patients arrived later than 2 hours from the onset of symptoms. A previous information about acute coronary syndrome, history of hypercholesteremia, arrived by ambulance, and increased pain intensity were associated with pre-hospital delay. The study recognizes the need for educational programs about acute myocardial infarction symptoms and the benefits of availing an ambulance service.

Objective:The aim of this study is to determine the quality of life and associated factors of physicians in residency training programmes in Al Madinah city. Methods:A cross-sectional study was conducted in three training centres including four main specialities (family medicine, paediatric, internal medicine and surgery) in Al-Madinah, Saudi Arabia. A self-administered questionnaire was used that included socio-demographic and occupational characteristics, and the short version of Arabic World Health Organization quality of life questionnaire (WHOQOL-BREF). Appropriate statistical analysis were used, including t-test, analysis of variance (ANOVA) test, and multiple linear regression models. Results:The highest mean score was in the environmental domain, followed by physical, social, and mental health finally, with score of 75.6%, 53.1%, 50.8%, and 49.2% respectively. The mean score of overall QOL and health satisfaction was 54.1%. In multiple linear regression analysis, gender was a significant predictor for overall QOL, overall health satisfaction (P<0.001), psychological (P<0.001), physical (P<0.001), and environmental domains (P= 0.014). Physicians without chronic disease had better overall QOL, and psychological score compared to physicians with chronic disease (P= 0.038, P= 0.032, respectively) Married physicians had better social health (P= 0.010) and obese physicians had poorer QOL and overall health satisfaction (P<0.001). Conclusion:This study found that male physicians, compared to females, had better QOL in the four domains of health. Obese physicians had poorer overall quality of life and health satisfaction relative to non-obese physicians. Physicians without chronic disease had better overall QOL, and psychological score compared to physicians with chronic disease. Married physicians had better social score.