Background: The evolution of information technology has continued to put pressure on healthcare systems to switch from manual to electronic systems. The electronic health record is a leading information technology system that has drawn considerable interest from governments and private health facilities. However, EHR implementation has proved to be a problematic endeavor, especially in developing countries. Objective: This review sought to determine the influence of EHR implementation on healthcare quality in hospitals and identifying applicable lessons for EHR implementers in hospital settings. Methods: Relevant literature was searched in the identified databases, including Scopus, PubMed, CINAHL, PsycInfo, and Cochrane Library. Websites such as the World Health Organization and the National Institute for Health and Care Excellence were searched for policies and guidelines. The study used several terms and their variations to create a search strategy, including electronic health records, hospitals and, healthcare quality. The literature search was constrained to the English language and studies published between 2010 and 2020. The study carried out a narrative synthesis of results from the included studies. Results: Overall, the findings of the systematic review demonstrated that EHR has a significant positive influence on healthcare quality by enhancing patient safety and ensuring effective, efficient, timely, equitable, and patient-centered care. Some of the EHR functionalities that facilitate quality healthcare include, practice management, communication, documentation or data entry, and medication management, decision support functionality, computerized drug prescription, electronic nursing documentation, and electronic management records. EHR implementation is faced with several challenges, which can be grouped into institutional side factors, human resource factors, technological factors, and ethical issues. Conclusion: We established a significant effect of EHR implementation on several healthcare quality indicators, namely patient safety, effective care, efficient care, timely care, equitable and patient-centered care. EHR implementation is faced with challenges emanating from the healthcare institutions, healthcare professionals, technology, and ethical issues. There is a need to devise an effective mechanism that would minimize the challenges that prevent successful EHR implementation in hospitals.
Purpose: Implementing standard health indicators aims at harmonizing fragmented information systems. However, they have not always met this expectation. This article argues that standard information systems fail because organizations fail to learn effective ways of solving problems. Design: Using an interpretive phenomenological approach, we draw examples from the implementation of standard health indicators in Cameroon to explore why organizations fail to learn. We collected data from April and September 2017 from 25 staff in healthcare facilities and district offices. Findings: Staff at the peripheral level encountered multiple levels of organizational challenges. We argue that these challenges are deeply rooted in the organizational structure. Using organizational learning as a lens, we theorize the factors (i.e., a disincentive for learning, educational barriers, and organizational culture) that hinder learning. Then identify three beliefs (i.e., technological fix, silver bullet, and emperors of the same empire) embedded in organizational structure that hinder organizational learning. Finally, we propose practical measures to mitigate the challenges that impede the implementation of standard health indicators in Cameroon and beyond. Conclusion: Organizations often misplace their attention on what and how they should learn. While they are fast to learn from external sources and are often eager to accommodate information systems, they fail to provide a conducive atmosphere where local experiences thrive, do not value learning from experiences, and adopt few processes to promote learning. Originality: Linking the challenges encountered by staff at the peripheral level after implementing standard health indicators to poor organizational learning opportunities offers a novel perspective to conceptualize the challenges of implementing information systems in low and middle-income countries.
Background: The use of information communication and technology (ICT) in Nigeria has been proven to have changed how the treatment is provided for both in-patients and out-patients in health facilities. Yet, information about their availability is rare. This study aimed to determine the availability of ICTs in Nigerian healthcare facilities. Methodology: This was a facility-based survey conducted in 872 healthcare facilities in 33 states of Nigeria with the Federal Capital Territory, Abuja, from May to July 2019. Data collection included individual interviews and site inspections. The data collected were analyzed with IBM-SPSS 25.0. Results: The study comprised 113 private and 759 public health facilities. The proportion of private and public facilities that use log forms recording orders was 86.7% and 79.8%, respectively. Computer availability was 52.2% in private 24.6% in public healthcare facilities. Basic handsets were the most available ICT tool, with 79.6% in private and 74.6% in public health facilities, mainly acquired by staff members. Availability of Local area network (LAN) was (23.9% vs. 8.4%) and WiFi (13.3% vs. 3.7%)) in private and public health facilities, respectively (p 0.05). In contrast, the use of ICT for other medical functions such as patient records and supply chain management was very shallow. Conclusion: There is a need for government and donor agencies such as the WHO and the United Nations to collaborate to ensure the provision of ICTs to Nigerian healthcare facilities.
Background: Otitis media (OM) is a widespread infection among children, which might hinder the acquisition of language. A myriad of individual studies has been found in the literature that reveals an inverse association between OM and language acquisition, however, the evidence from such studies is not reviewed and synthesized. Thus, we conducted a systematic review to integrate findings regarding the impact of OM on language acquisition among young children. Methods: A wide range of electronic bibliographic databases such as PubMed, Embase, and ERIC was searched. Based on the eligibility criteria, all observational studies and one randomized controlled trial conducted from 2000 to 2020 were incorporated in the review. Following screening and assessing the abstracts, we ended up reviewing 11 articles, and data were extracted on important parameters such as country, sample size, study design, time of follow-up, and primary outcomes. Results: Overall, the findings of the systematic review were mixed. However, the majority of the studies revealed a negative or inverse relationship between OM and various domains of language development among children. Generally, the eligible studies revealed that OM is negatively associated with language acquisition and can affect different domains such as receptive or expressive language. However, there were also some null findings from very limited studies. Conclusion: The findings of this review may be considered imperative for the clinicians and physicians who treat children with OM because OM is mostly not severe and can be ignored. Given the effects of OM on various language domains, one needs to be vigilant while approaching the child with OM to prevent developing adverse effects of OM on language development.
Background: The high turnover in Registered Nurses (RNs) is a critical indicator of the nurses' job market and an undesirable trend for healthcare employers. Nurse turnover is expensive and jeopardizes the quality of care and patient safety. This research aims to identify the most significant factors that have a strong influence on the nurse turnover rate in King Fahad Armed Forces Hospital. Methods: A quantitative method was employed to gather the data regarding the factors influencing nurse turnover. A cross-sectional design was adopted for this research. The study population was 1,186 non-Saudi RNs, and the sample size is 297 RNs. The data from the questionnaires were analyzed using Minitab and Microsoft Excel software. Results: Based on the test results, their workload is statistically significant with nurse's turnover. Factors linked to workload co-varies with nurse turnover; specifically, as the degree of dissatisfaction increases, the nurse turnover increases and, conversely, as the degree of satisfaction increases, the nurse turnover decreases. Similarly, as the degree of satisfaction in beneficiary factors increases, the nurse turnover decreases. The third test of the relationship between the nurse turnover and the organizational culture exhibits strength and direct association and concludes that, as the degree of satisfaction in the organizational culture increases, the nurse turnover decreases and vice versa. Conclusion: In general, the organizational culture is the strongest contributing factor, while the workload factors are shown to be the least strong contributing factor to why nurses are leaving their jobs, leading to the rise in the turnover rate. The recommendation made by this study is that organizations must develop an effective strategic retention plan to support and encourage the nurses through increasing salaries and incentives, continuous job promotions, and suitable development practice as, if the organizations do not apply these kinds of strategies, high turnover will remain a problem and organizations will not be able to come up with appropriate solutions.
Background: The type 1 diabetic population has an increased incidence of thyroid dysfunction, accounting for approximately 17-30%. Thyroid dysfunction may interfere with insulin sensitivity and insulin requirements in individuals who have type 1 diabetes. This study aimed to find an association between thyroid function and poor glycemic control among adults with type 1 diabetes mellitus using TSH and HbgA1C, respectively. Methods: A cross-sectional study was conducted in King Abdulaziz Medical City, Riyadh – Kingdom of Saudi Arabia (a tertiary hospital). Our subjects were adults with type 1 diabetes mellitus who had their TSH levels tested, between 2015 to 2019. Patients were categorized based on their TSH level as either hypothyroid, hyperthyroid, or normothyroid. The following variables were measured: patient’s demographics, Thyroid-stimulating hormone level, the presence of anemia, WBCs, LDL level, and history of diabetic ketoacidosis. Results: There were a total of 1425 adult patients with T1DM between 2015 and 2019, only 282 patients fulfilled our inclusion criteria. 36.2% were males (N=102) and 63.8% were females (N=180). The patients’ mean age was 27.03 years with an average BMI of 25.62 kg/m2. 18.4% were hypothyroid and 9.9% were hyperthyroid. Our subjects had a mean HbA1c of 8.76%. hyperthyroid patients had higher HbA1c levels with a mean of 8.907 while hypothyroid patients had a mean of 8.11%. Also, we have found that patients with hyponatremia tend to have poor glycemic control in comparison to hypernatremia and normal serum sodium. We found that age, TSH, having a history of diabetic ketoacidosis and serum sodium to be significantly associated with HbA1c with P-values of 0.016, 0.012, 0.005 and <0.001 respectively. Conclusion: Thyroid dysfunction was observed in a high proportion of our patients. We have found a clear association between thyroid function and glycemic control among adults with type 1 diabetes mellitus. Glycemic control was better among hypothyroid patients compared to hyperthyroid and normothyroid patients. Also, glycemic control is poor in hyponatremia in comparison to hypernatremia and normal serum sodium patients. HbA1C was significantly associated with age, TSH, serum sodium, and having a history of diabetic ketoacidosis but not with gender, body mass index and LDL level.
Background: The study intended to measure the family physicians’ perspectives towards electronic health records (EHR) privacy and explore the factors determining these perceptions. Methods: All the primary care physicians were invited to participate in the online survey using a validated Health Information Privacy Questionnaire (HIPQ). Four themes were evaluated - (i) ability of computers to keep health information private (ii) accessibility to outsiders use (iii) sharing of health information with other health professionals and (iv) benefits versus risk of computerized health information. Descriptive statistics were reported for categorical and continuous data while student-t test and ANOVA were used to quantify association. Results: Majority perceived EHR to be more private than the paper-based records while some disagreed and expressed concern about data leakage. Senior physicians (p=0.05), non-Saudi’s (p=0.029) and consultants (p= 0.004) well perceived the privacy of computerized information. Many physicians agreed to sharing of data with the Ministry of Health (53/89; 59.6%) and hospital-based research centers (49/89;55%) but did not favor data accessibility and sharing with insurance and pharmaceutical companies. Most of the respondents (48/89;54%) disagreed to the risk of possible loss of confidentiality using EHR. Higher age (p=0.018) and consultant rank (p=0.024) were strong predictors of higher scores for overall benefits of EHR and its usefulness in healthcare delivery planning. Conclusion: The EHR does not compromise the privacy, safety and confidentiality of patient health data. The physicians acknowledged the perceived usefulness of e-health systems and advocate its implementation in larger hospitals across Saudi Arabia. However, there is a need to devise multiple strategies to prevent data leakage and breach in confidentiality by non-hospital sources.
Teledermatology is a reliable tool for remote consultations. It’s significance was greatly enhanced during the COVID-19 pandemic. The teledermatology model proposed by our study used WhatsApp as communication modality to reach-out non-COVID patients especially in a low-income setting. We used store and forward method of telemedicine and observed effective communication on behalf of the patients irrespective of educational status. This model was time efficient for the practitioners and provided a cost-effective solution to the Dermatology patients in re-mote settings, unable to access healthcare facilities during lockdown. Our study supports the use of free mobile applications such as WhatsApp messenger that the patients are already using for social networking and communication to reach out Dermatology patients cost effectively, particularly in low resource settings and in challenging circumstances such as COVID 19 pandemic.
Background: Despite increasing majority of adolescents having access to Internet every day, there is need to understand why a significant minority still lack access to Internet and social media, which is a form of digital inequality in the 21st Century. Aim: To assess the rate of Internet access and use of social media among secondary school adolescents in Nigeria with comparative emphasis on socio-demographic variables among students in public and private schools. Methods: A descriptive, cross-sectional study was conducted in four (2 public and 2 private) secondary schools in Ile-Ife, Osun State. A stratified sample of 596 Senior Secondary School (SSS) students (291 public, 305 private) were randomly selected across class levels from SSS 1 to SSS 3. Data collected were analyzed with SPSS version 26; using descriptive (frequency, percentage, mean and standard deviation) and inferential statistics (Chi square). Results: Almost all private secondary school students (97.7%) had access to Internet, compared to 82.3% of students in public schools. Majority of the students that have access to the Internet were between the age 14 to 16years (75%), females (73.7%), and of Yoruba tribe (90.2%). Likewise, 63.5% of students in private and 41.2% of those in public schools have used social media. Nonetheless, 17.7% vs. 2.3% of the respondents in public and private schools have never browsed the Internet respectively. Six socio-demographic variables (gender, religion, school type, class level, residence after school and weekly pocket money) statistically influenced access to social media significantly (p<0.05). Although 52.1% of the overall student sample that had access to Internet, regularly use social media; there was no significant association between the level of Internet access and use of social media (p = 0.280). Conclusion: Adolescents in private schools have higher Internet access and use of social media than those in public schools. Since more than one-third of adolescent students in secondary schools do not use social media as desired, due to some significant socio-demographic limitations; the adoption of a hybrid approach of online and offline channels of health communication and education is best recommended among school adolescent population in Nigeria.
Background: The patient-reported data is the primary source for studying patient-related topics such as treatment satisfaction, quality of life, compliance to treatment, and many others. Collecting the data could be from surveys or interviews. To make use of patient-reported data, quality, reliability, and validity of the data must be considered before using the data. There are many difficulties associated with collecting data from patients. Recall bias is one of the expected issues with patient-reported data. Patients may have difficulties remembering clinical encounters or relevant information about symptoms or medication side effects. Problems include over-reporting or under-reporting of information. Factors affecting the recall bias include many factors such as cognitive problems, memory issues, and a long time (more than six months) between the encounter and recalling the details. Aim: The aim of this study is to identify the barriers that prevent patients from providing valid data for clinical or research purposes focusing on the population of Saudi Arabia. Methods: An online survey that discusses data collection barriers was distributed to clinicians and researchers who have experience in the field. We applied theme-based analysis to analyze the responses and identify the most relevant barriers and the solutions suggested by the respondents. Results: Our sample included six participants with experience ranging from 10 to 33 years. The main issues for patient-reported data collection were fear of judgment and concerns for information privacy. The respondents suggested to assure the patients or collect the information using anonymous electronic surveys. Conclusion: Patients/participants in the kingdom, similar to patients in other countries, are concerned about the exposure of personal information that may fear that it exposes them to societal judgment. Assurance of privacy and establishing trust with the patient allows for better collection of valid data.
Background: Waterpipe (WP, Shisha) smoking is one of the sub-types of Tobacco use, which has been used increasingly across the globe over the past several years. This upsurge in the WP smoking could be partly attributed to some of the factors such as lack of knowledge regarding health-related hazards associated with tobacco use and the absence of intensive preventive programs focusing on cigarette smoking. Objective: The objective of the study was to knowledge, attitudes and practices towards Water Pipe smoking among adults in Saudi Arabia. Participants and Methods: We undertook a cross-sectional study at four primary care centers in Riyadh city of Saudi Arabia. We identified and enrolled 300 Saudi adults using a stratified random sampling method. We performed logistic regression analysis to analyze the data. Results: Of the total participants, 147 (49.0%) were current smokers and 47.6% of these current smokers were WP smokers. Of the current WP users, the majority (87.1%) were males. Further, 28% of the study participants stated that WP is less harmful and 56% mentioned that WP has less addictive properties as opposed to cigarettes. More than half of the study participants started WP smoking at an age younger than 20 years. Around 90% of the participants knew that WP smoking could cause lung cancer. Conclusion: WP smoking was found to be a relatively common practice among adults of Saudi Arabia. The government of Saudi Arabia needs to design some cost-effective and sustainable interventions to help adults to avoid this harmful behavior. Future studies are required to understand the factors of such behavior among adults Keywords: Perceptions, Behavior, Waterpipe, Shisha smoking, Adults, Saudi Arabia.
The adverse effects of COVID-19 have affected the teaching and learning opportunities across many disciplines including medicine. Although, control measures due to COVID-19 might be beneficial for medical students or health college students in the short run they might prove harmful in the long run. This opinion article aims to provide an overview of how COVID-19 has affected medical education and how to improve clinical teaching and learning environment to keep educating physicians of the future. Different articles were searched from Google Scholar and PubMed. We undertook a review of full-text research articles that were published in the English language both in developed and developing countries with a specific focus on teaching and learning in medical or health colleges during the COVID-19 outbreak. We evaluated research articles and reviewed their references to avoid missing any article relevant to the topic of interest. Social distancing due to COVID-19 has prevented medical and health college students from gathering in large classrooms, auditoriums, and even in clinical settings such as wards. Moreover, most of the countries in the developing world shut down colleges and universities, which resulted in a gap in learning and education. Therefore, innovative and smart approaches and strategies need to be adapted in the field of medicine to overcome the challenges of gaps in learning and teaching. Online approaches such as zoom and skype could be adapted by the colleges with breakout sessions and simulation exercises to maintain the optimum learning and teaching environment in the health colleges and education with maximum support from the IT department. During the COVID-19 crisis, it is essential that the medical or health colleges and universities to devise and revise the old pedagogies and approaches of learning and teaching. In addition, the lecturers and professors in these universities need to prioritize scholarly and innovative approaches to implement more practical and sustainable solutions. This is the time to get the maximum benefit out of technology to develop and implement novice online ways of teaching and learning.
Background Given the rapidly evolving field of mobile health to improve the quality of low-resource health services, we aimed to evaluate the user patterns of the Safe Delivery App, mHealth clinical training tool in Basic Emergency Obstetric and Neonatal Care, among health workers in Ethiopia. Methods Sixty-one health workers were included from the intervention arm of the cluster randomized controlled trial of the Safe Delivery App, a teaching aid using animated movies to improve quality of obstetric and neonatal care. Observational data on user patterns was collected from November 2013 to November 2014 in five rural districts in Ethiopia and automatically registered by GPRS (General Packet Radio Service) or GPS (Global Positioning System) network. The registered information included topic of movie and the movie sub chapter being watched as well as the date, time and location of the usage. Results During the 12-months trial period, 61 health workers watched in total 20,049 training sub chapters. The app was used frequently with an average of 26 sub chapters viewed per health worker in a month. A sustained level of usage throughout all 24 hours of the day was seen. The health workers were particularly interested in strengthening their ability in giving an uterotonic drug and managing the newborn’s airway with almost twice as many views when compared to the other videos. Conclusions User patterns showed consistent and frequent usage of the Safe Delivery App throughout the 12 months trial period. Our findings highlight the relevance of innovative training methods for health workers in low-resource countries.
Background: The objective of the study was to describe the characteristics and comorbidities of chronic diseases in patients visiting a major governmental clinic in Northern Riyadh, Saudi Arabia. Methods: This descriptive cross-sectional study examined 183 patients visiting a major governmental clinic in northern Riyadh, Saudi Arabia. The visits were conducted between December 2019 and January 2020. A predesigned data extraction sheet was used to collect data from electronic medical records for baseline demographics of patients and clinical features of diagnosed diseases. Results: The mean age of patients was 60.25 years ( SD ±12.3). The mean systolic and diastolic blood pressure was 130.97 mmHg (SD: 12.26) and 68.72 mm Hg(SD: 2.16) respectively. The mean body mass index (BMI) was 31.78 kg/m2 (SD: 6.48). On categorizing BMI values, 104 (59.4%) patients were obese and 55 (32.4%) were overweight. The majority of the patients had dyslipidemia (83.6%). Female patients significantly suffered from arthritis and hypothyroid more than males (34.4% vs 4.7%, p-value <0.001 and 26.7% vs 8.2%, p-value 0.001) respectively. However, other chronic diseases did not show any differences with respect to gender. With respect to age group, hypertension (78.9% vs 21.1%, p value <0.001), dyslipidemia (88.9% vs 11.1%, p value 0.05), diabetes (77.8& vs 22.2, p value 0.05) were significantly higher among individuals from the age group of 60 and older. With respect to comorbidity, the most common comorbidity associated with diabetes was hypertension (71%, p = 0.015), while 87.2% of individuals with dyslipidemia were also diagnosed with diabetes (p = 0.03). Conclusion: Dyslipidemia was found to be the most frequent chronic condition, followed by diabetes, Hypertension, arthritis and other health conditions (cancer, depression, anxiety, and dementia). Hypertension, dyslipidemia and diabetes were more commonly found in elderly patients (≥60years). Comorbidity was also predominant in our study population. The significant comorbidity of diabetes with both hypertension and dyslipidemia among visitors of primary healthcare settings necessitates the selection of appropriate treatment strategies that aim to control these three conditions together while minimizing the number of adverse effects related to interactions between medications. There is also a need for a greater nation-wide study to extrapolate these findings to Saudi primary healthcare settings.
Background COVID-19 has affected not only the timely and effective care for orthopedic patients but also new directions and plans in the field of orthopedics. However, there is no evidence about how this pandemic or COVID-19 era will shift the care or will bring transition in the field of orthopedics medicine or surgery. Hence, the purpose of this review is to evaluate the effects COVID-19 on orthopedics surgery, the challenges facing experts in the field, and the new opportunities driven by the COVID-19 pandemic. Material and Methods Different articles gathered from databases such as Google Scholar and PubMed. This is a narrative review of full-text research articles published in the English language both in developed and developing countries with a specific focus on Orthopedics and COVID-19. The paper examined original research articles for information pertinent to the objective. It also reviewed all references of the eligible article to avoid missing any article relevant to the topic of interest. Findings The findings demonstrate that overall orthopedic surgeries and other services have been affected due to the COVID-19 pandemic. The frequency of different procedures has significantly declined across different countries and regions. Older adults are affected more than younger. However, the decline in the number of procedures for younger patients are affected. An integrative and collaborative team approach must be adopted by the orthopedic surgeons to address the anticipated increased patients'flow in the near future. In addition, telemedicine can be integrated into the field of orthopedics to provide remote care to the patients whenever required. Conclusion Since COVID-19 has suddenly disturbed most of the orthopedic procedures and activities in both the outpatient and the operating room, surgeons need to devise new strategies to overcome these challenges without compromising the patient's care.
Background: Sick Building Syndrome (SBS) is a state of discomfort and irritation in several body systems which affects employees in a closed office work environment. It has a 30% reported prevalence worldwide. This study aimed to determine the prevalence of Sick Building Syndrome and its associated symptoms. In addition, it also aimed to investigate the association between closed offices environment and the risk of Sick Building Syndrome as well as identifying its associated risk factors and its correlation to in the Medical City in Riyadh, Saudi Arabia. Methods: This cross-sectional study was conducted using a self-constructed questionnaire for data collection among office workers in four different during the year 2018. Convenient random sampling was then used to select study subjects for the study. Results: A total of 373 subjects participated in the study. SBS prevalence among office workers was found to be 20%. The study found that being female (OR 2.80; [95%CI: 1.61-4.84]), higher stress level (OR 2.885; [95%CI: 1.001-8.32]), allergies (OR 2.25; 95%CI: 1.32-3.85]), temperature fluctuations (OR 1.84; [95%CI 1.04-3.26]), noises (OR 1.83; [95%CI: 1.09-3.06]), and a cumulative exposure level to office conditions (OR 2.48; [95%CI: 1.47-4.16 ]) increased the likelihood of SBS. Four out of six SBS symptoms were reported in more than a quarter of the employees, while five symptoms were significantly associated with building types. Age and the number of years working in the same building or office were found to be protective factors (OR 0.64, OR 0.69, OR 0.75) respectively. Conclusion: The high prevalence of SBS among office workers should attract attention to the existence of sick buildings in Saudi Arabia. Awareness and preventive measures should be adopted by the responsible entities of these sick buildings to reduce the health effects of SBS among office workers.
Background The use of telephone consultation services has been recently introduced in Saudi Arabia through Seha Mobile Application (Seha App) and Medical Consultation Call Center (937). Existing literature provides evidence that public satisfaction with such services is high while health care providers find it stressful and difficult. Aim To determine the utilization pattern of telephone consultation services in Saudi Arabia and appraise the level of satisfaction towards this services among health care providers and consumers. Methodology A cross-sectional study was undertaken at the Medical Consultation Call Center, Saudi Arabia. The health reports for the period January to June 2018 were reviewed to determine the utilization pattern. Data regarding the satisfaction of health care providers was collected through an online questionnaire and data on satisfaction of consumers was collected through telephone interviews from June to August 2018. Results Telephone consultation services are increasingly being utilized by the Saudi population. Most consumers were highly satisfied with the service, mostly with the ability of health care providers to interact with the callers, the length, waiting time and outcome of consultation. Similarly, most of health care providers were generally satisfied with the service. Conclusion The study recommended introducing an array of specialties and training of health care providers to create a supportive environment and maintain adequate staffing levels.
Introduction Appropriate management of anaphylaxis is vital to save patients’ lives. However, the management of anaphylaxis can be daring for many reasons. Moreover, it has been found that anaphylaxis is inadequately diagnosed and managed in the hospitals of different countries of Middle East and Eastern Mediterranean, which might be due to the gaps in the knowledge, attitudes and practice preferences of Emergency Room (ER) physicians. Thus, we aimed to assess the level of knowledge and practice attitudes of ER physicians regarding anaphylaxis in some tertiary hospitals in Riyadh, capital of Saudi Arabia. Methods We undertook a cross-sectional survey of a convenience sample of all ER physicians working at three tertiary hospitals in Riyadh capital of the Kingdom of Saudi Arabia (KSA). A 20-item validated, and a structured questionnaire was used to collect the data. The study questionnaire was distributed to the physicians and 95 physicians responded to the study questionnaire in three hospitals. A descriptive and exploratory analysis was used to analyse the data. Results Of the total study participants, 76.8% were males and 39.6% had an experience of more than 10 years. More than a third and near to half of the physicians were aware of symptoms of anaphylaxis. Around 80.2% of the physicians showed a preference to give epinephrine to the patients when they arrived with anaphylaxis and 77.1% preferred the intramuscular route for administration of epinephrine in the thigh. Around 73.7% reported that they refer patients with anaphylaxis to an allergy specialist which is considered a proper follow-up. We only found a significant difference in the usage of epinephrine by different tertiary hospitals with a p-value of 0.027. We found a significant mean difference for the proper diagnosis of patients with anaphylaxis by gender (p-value: 0.035) and region for residency (p-value 0.037). However, we did not find any statistically significant difference regarding the management pathway at the ER regarding different types of the hospital (p-value: 0.162). Conclusion The study demonstrated that physicians of these three hospitals have basic knowledge regarding the management of anaphylaxis; however, strategies should be formulated to encourage the use of modern techniques such as the use of autoinjector. Educational programs for physicians and patients should be conducted. Further longitudinal studies with a large sample size should be conducted to build upon the findings of the current study.
Background:Smoking cessation clinics were established in Saudi Arabia in 2014 to control smoking among the Saudi population and contribute to realizing the Saudi vision 2030 of having a healthy nation. This study aimed to determine the frequency of smoking cessation and associated factors among consumers of Ministry of Health (MOH) clinics and to measure their satisfaction with the services provided. Methods:A cross-sectional study of 800 participants was conducted from June to December 2019 at MOH smoking cessation clinics in Saudi Arabia. A predesigned questionnaire was used to collect databy phone interview through the health consultation center (937) at (MOH). Results:The frequency of quitting smoking among the consumers of (MOH) smoking cessation clinics was 26.0% and the frequency of smoking relapse after quitting attempts was 52.3%. The main indicators of quitting smoking were related to contentment, self-efficacy and social, family support as well as counseling services and Nicotine Replacement Therapy (NRT) provided by these clinics. About 70% of the participants were satisfied with the services. Conclusion:Smoking cessation clinics in Saudi Arabia have played an important role in helping individuals to quit smoking. More attention must be payed to these clinics to ensure optimum level of service and medication provision. Keywords:Saudi Arabia, Smoking Cessation, Cessation Clinics, Relapse, Satisfaction.
Infantile fibrosarcoma is a disease characterized by rapidly progressing soft tissue tumors mostly over the distal extremities of children during their infancy period. The management of this cancer includes chemotherapy and complete surgical resection, which has previously shown a favorable prognosis and a greater overall survival rate. This case study is an examination of a child who presented with left wrist swelling at the age of six months. After his diagnosis, the child received nine cycles of chemotherapy before surgery and operated at 18 months of age. His post-operative history is unremarkable, and he did not show any signs of relapse or metastasis. Our case is suggestive of the hypothesis that chemotherapy before surgical excision results in a good prognosis and a greater survival rate. In the future, the patient’s condition should be followed up on regularly for the early recognition of recurrence.
