Introduction: World Health Organization advocates that 3-5% of the population should donate blood yearly. However, the donors in Saudi Arabia (SA) in 2011 represented 1.46% of the population. This study aimed to assess knowledge, attitude and practice concerning voluntary blood donation among health professions students in Saudi Arabia and to determine the associated factors. Methods: This is a cross sectional study on 598 students. Chi-square and Fisher tests were used to analyze the significant association of blood donation and influencing factors. Results: Majority of respondents (360; 60.2%) showed sufficient knowledge regrading blood donation. A total of 593 participants (99.2%) believed that blood donation is important for the community. Around 180 (30.1%) of the respondents have donated blood before. Out of the participants, 422 students (70.6%) reported that they did not take any courses concerning blood donation in their colleges. However, 502 (83.9%) showed a high willingness to donate blood if their colleges organize a blood donation camp within campus. There was a significant association between knowledge level, current academic level and gender with practice of blood donation. Conclusion: Saudi health professions colleges’ role in promoting blood donation was notably missed. Students showed high willingness to donate blood if a blood camp was organized within the campus. The implementation of encouragement campaigns and educational sessions within the campus will have a great effect on blood donation.

IMPORTANCEThe treatment plans of patients with cancer involve multiple modalities that oncologists need to explain to patients. One such modality is chemotherapy, in which information about the goals, duration, and expected complications of therapy are considered fundamental to achieving optimal patient understanding. Therefore, effective communication between patients and their treating physicians is important to ensure patient adherence to treatment and achieve better outcomes. OBJECTIVETo investigate the concordance in the understanding of chemotherapy treatment plans between patients and their treating oncologists and to identify the potential factors associated with concordance. DESIGN, SETTING, AND PARTICIPANTSA cross-sectional study was conducted among adult patients (aged >18 years) with cancer who consented to receive chemotherapy between October 4, 2017, and November 8, 2018. The study also included the treating oncologists of patients receiving chemotherapy. An interview-based structured questionnaire was administered in both inpatient and outpatient settings at the Princess Noorah Oncology Center in Jeddah, Saudi Arabia. The demographic data of patients and physicians were obtained from the ARIA Oncology Information System, a chemotherapy-prescribing software database used at the center. Patients who had a personal history of cancer or were unwilling to be involved in the decision-making process were excluded. Data were analyzed from November 15 to December 20, 2018. EXPOSURES Patients' comprehension and concordance with their treating physicians regarding the aspects of the intended treatment plan. MAIN OUTCOMES AND MEASURESThe main outcomes measured were the patient-physician concordance level in the understanding of treatment plans and the identification of patient-related and physician-related factors associated with the level of concordance. RESULTSA total of 151 adult patients (77 men [51.0%] and 74 women [49.0%]) were interviewed.Of those, 144 patients (75.5%) were younger than 60 years, and 52 patients (34.4%) had a college or advanced degree. A total of 20 treating oncologists were interviewed, of whom 14 (70.0%) were men and 6 (30.0%) were women. Arabic was the primary language of 19 oncologists (95.0%), and 19 oncologists (95.0%) had medical practice experience outside of Saudi Arabia. Only 20 patients (13.7%) had full concordance with their physicians regarding the aspects of their treatment plans.The remaining 131 patients (86.2%) had discordance with 1 or more aspect of their treatment plans.The most common aspect of discordance was the planned duration of the chemotherapy regimen, with 104 patients (68.4%) having full discordance. Full patient-physician concordance was more likely among patients with college or advanced degrees (χ 2 1 = 17.73; P < .001) and patients with a family history of cancer (χ 2 1 = 15.88; P < .001). In addition, older physicians (>40 years) compared (continued) Key Points Question Do patients with cancer understand the treatment plans to which they consent? Find...

Familial hemophagocytic lymphohistiocytosis (HLH) is a fatal autosomal recessive disorder resulting in an exaggerated and ineffective immune response. Genetic defects in familial HLH can lead to the impaired function of the secretory lysosome-dependent exocytosis pathway. We report an STXBP2 homozygous missense mutation c.1139A>G, p.(Gln380Arg) consistent with a genetic diagnosis of familial hemophagocytic lymphohistiocytosis type 5 associated with chronic diarrhea in a seven-year-old girl. She was diagnosed with HLH and achieved remission by the HLH-2004 protocol and allogeneic matched bone marrow transplantation (BMT) from her sibling. However, six years later, she had a relapse of HLH, which required a second BMT. Ever since then, she continued to have persistent chronic watery diarrhea and failure to thrive. Patients with familial HLH type 5 due to STXBP2 gene mutation can manifest as either with or without chronic diarrhea. This unusual relationship directs toward a specific gene mutation of STXBP2 as the cause of chronic diarrhea in familial HLH. The prevalence of familial HLH in Saudi Arabia is underestimated. Due to the high rate of consanguinity and the local customs of marrying within the same community, clinicians should consider familial HLH as a cause of persistent, unexplained, chronic diarrhea among the pediatric age group.