Improvement of the modifiable factors as nurses' income and shift time is needed for better QOL and job satisfaction.

+ T-cell lymphoma, and six CD30 + lymphoproliferative disorders (three lymphomatoid papulosis and three anaplastic large-cell lymphomas). In addition, 43 samples from patients with ID were identified.The performance of the HTS TRB technique for CTCL diagnosis was analysed using receiver operating characteristic (ROC) curves on 101 cases of CTCL and 43 of ID. As shown in Figure 1(a, b), the TCF showed the highest diagnostic performance, with an area under curve of 0Á96, vs. 0Á93 for RPF. TCF and RPF values by definite diagnostic categories are shown in Figure 1(c, d).With 5% and 25% TCF thresholds, the specificities for CTCL diagnosis were 95% and 100%, and sensitivity 89% and 50%, respectively. Such a high specificity allows early identification of CTCL in difficult cases. One of our patients had a skin biopsy showing spongiotic dermatitis 2 years before a definite SS diagnosis. Retrospectively, HTS performed at that time already showed a TCF of 59% in skin, which corresponds on the ROC curve to a specificity of 100% and a sensitivity of 84%. Only two patients without CTCL (dermatitis and prurigo) had a TCF > 5% in skin: one died of a stroke and the other is still alive 2 years after the diagnosis. There was a significant Spearman correlation between TCF and blood tumour burden in patients with SS (absolute numbers of CD4 + CD26 À T cells, r = 0Á59, P < 0Á001; CD4 + CD7 À , r = 0Á45, P = 0Á01; CD4 + CD158k + , r = 0Á4, P = 0Á03). Clonality analyses in skin and blood were performed by HTS TRB and PCR of TRG in nine patients with SS. Both techniques identified an identical T-cell clone in all blood-skin couples of samples, except in one blood sample in which a dominant T-cell clone was identified by HTS TRB, identical to the skin, but no dominant Tcell clone was identified by PCR.In conclusion, the TCF of TRB determined by HTS was a robust criterion for CTCL diagnosis, and especially useful for early-stage MF, with 95% specificity and 89% sensitivity at the 5% threshold. This compares with 88% specificity and 72% sensitivity using PCR of TRG. 8 This threshold is identical to that used in the study by Sufficool et al., 7 who used HTS of TRG and found 85% sensitivity for CTCL diagnosis (specificity was not analysed because no cases of ID were included). Rea et al. 8 used HTS TRB clonality score and found 100% specificity and 68% sensitivity at the 0Á175 cutoff. In our dataset, clonality score was less accurate than TCF. Further multicentre prospective studies are needed to validate international criteria for T-cell clonality analysis by HTS of TCR genes in the diagnosis of CTCL.

Objectives: To assess the knowledge, awareness, and perception about amblyopia and related disease dimensions among the parents and companions of children attending the pediatrics and ophthalmology clinic. Methodology: A prospective cross-sectional study was conducted using a semi-structured questionnaire including the companions of children who attended the Pediatrics and Ophthalmology clinics at King

Original Research ArticleAwareness, knowledge and behavior of medical personnel regarding skin cancer, sun-related hazards and sunscreen utilization at ABSTRACT Background: Worldwide, skin cancer is a major public health concern. It is a common malignancy in Saudi Arabia. The three most prevalent types of skin cancer are basal cell carcinoma, squamous cell carcinoma and melanoma. Exposure to ultraviolet (UV) radiation is the most common modifiable risk factor to lower the risk of the leading types of skin cancer. Practicing protective measures can aid in decreasing the risk of developing skin malignancies. Methods: Data collection took place at King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia. This crosssectional study was conducted via a structured self-administered questionnaire among medical personnel. Results: The majority (81.9%) of the sample participants were Saudi citizens. Moreover, medical students of 4th year, 5th year and 6th year represented half of the sample. Mean±SD values for the knowledge, behavior, and awareness scores were 6.85±3.31, 8.57±5.00, and 17.75±7.05 respectively. There was no statistically significant difference in mean awareness score for the various categories of demographic variables. One-way-ANOVA revealed statistically significant difference among the different job titles in terms of awareness score with a p value <0.001. Conclusions:The results of this study have shown that the knowledge regarding skin cancer and behavior towards sun exposure is inadequate. Therefore, increasing the knowledge in the form of awareness campaigns is highly recommended.

Background: To assess the knowledge, awareness, and perception about strabismus and related disease dimensions among the parents and companions of children attending the pediatrics and ophthalmology clinic. Methods: A prospective cross-sectional study was carried out between 01 January and 31 July 2017 including the companions of children having strabismus who attended the Pediatrics and Ophthalmology clinics. A semi-structured questionnaire was developed to collect data. Results: The study included 474 companions of children (69.8% females). Knowledge about strabismus definition was correctly identified in 61.1%-74.6% of the participants. Heredity was the most frequently identified etiology (68.9%), followed by trauma (61.3%). Regarding treatment options, 63.6%, 60.6% and 47.8% of the participants correctly identified glasses, surgery and eye muscle exercise as possible options to treat strabismus, respectively. Most frequent knowledge sources were relatives and friends (69.8%) and the internet and social media (56.3%). Parents' role was highly appreciated as perceived by the participants, particularly for early detection (93.4%), diagnosis (92.0%), compliance with treatment (94.7%) and follow-up (92.4%). Both genders showed moderate knowledge about strabismus with a significantly higher level of knowledge in female participants (P=0.001). The Educational level had no impact on such parameter. Conclusion: There is high awareness level about different strabismus dimensions but with several misconceptions related to its psychosocial and economic consequences, a matter which could impact parent's vigilance and involvement in the therapeutic and preventive programs. It is necessary to target information messages and awareness programs in a comprehensive manner to all populations without an educational-based discrimination.