Attitude of Saudi Plastic Surgery Residents Toward Pursuing Burn Practice.

Burn injuries comprise the most common accidents worldwide. The delivery of burn care has been adversely affected by the absence of effective burn management and aesthetic services. This study attempts to address the attitude of Saudi residents of plastic surgery toward obtaining a burn fellowship and to examine the factors that might influence their decisions in this regard. An online survey was sent to 39 plastic surgery residents in Saudi Arabia including levels from PGY 1 to 6 in the academic year of 2019. The questionnaire was used to demonstrate interest, knowledge, and major factors influencing or discouraging residents from choosing Burn as a subspecialty in their future career. Residents responded to knowledge questions on a scale of 3 (below average/average/above average). The response rate was 84%. Thirty-three residents completed the questionnaire. The age group was between 30 and 34 years. Only 27% of the respondents expressing interest in burn practice. The main factors that make the plastic surgery resident avoid pursuing burn fellowship were multiple operations sessions, lifestyle, financial outcome, and emotional aspects. On the other hand, the paucity of burn surgeons and being involved in the humanitarian mission were attracting factors. Most of the residents believe that burn must be obligatory and continue to be part of all plastic surgery training programs (100%). In Saudi Arabia, the relative paucity of specialist mentors on plastic surgery programs may limit residents' exposure to subspecialties such as burn during plastic surgery rotational experiences. The findings from this survey may help plastic surgery program directors or burn surgeons, in particular, to find out strategies to attract future trainees.

Arteriovenous Malformation of the Upper Eyelid: A Case Report.

Arteriovenous malformations (AVMs) are rare lesions formed by direct connection of arteries and veins bypassing capillary beds. AVM locations can vary; however, extracranial AVMs remain the least common. The vast majority of these malformations are congenital and can be triggered by hormonal changes. A 49-year-old woman presented with a progressive right-sided upper eyelid swelling over the past 12 years. The patient had mechanical ptosis and mild impairment of the right visual field. The swelling was compressible with a thrill, and bruits were heard. The patient was diagnosed with AVM using cerebral angiography. Preoperative endovascular embolization was not possible; however, surgical excision was successfully done with no complications. AVMs and fistulas are high-flow vascular lesions that usually occur during childhood and progress with time. Only a few cases of face and eyelid AVMs have been reported in the literature. Diagnosis of these anomalies is mostly made based on clinical presentation and radiographic imaging such as angiography. Treatment options remain controversial, and management should be individualized for each patient. Endovascular embolization followed by surgical excision is advisable in many cases. Due to its rare entity, information regarding the best management options for AVMs is limited. Reducing the risk of bleeding and achieving total resection is the goal of treatment. Long-term follow-up is required in these patients because recurrent cases of AVMs have been reported.

Melanoma and non-melanoma skin cancer among patients who attended at King Khalid University Hospital in Riyadh, Saudi Arabia from 2007 - 2018.

OBJECTIVES: To assess the prevalence of melanoma and non-melanoma skin cancer for patients attended King Khalid University Hospital, Riyadh, Saudi Arabia. We are also assessing the most common category of skin cancer to be encountered among those patients. Methods: The authors conducted a retrospective study including all patients (Saudi and non-Saudi) who attended King Khalid University Hospital (KKUH) at the period of (2007-2018). Data were collected from archives of Pathology Department at KKUH and categorized into: melanoma skin cancer (MSC), non-melanoma skin cancer (NMSC), which included: basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), pre-neoplastic lesions, and non-neoplastic skin lesions. Results: A total of 111 patients were reported to have skin cancer out of 9828 cases, which had other skin pathology. Majority of cases were basal cell carcinoma with a total number of 76 (68.5%) of all cases. 18 patients (16.2%) were diagnosed with MSC. The remaining 17 patients (15.3%) were diagnosed with squamous cell carcinoma. Conclusion: Skin cancer prevalence and incidence is increasing worldwide. In our study, BCC was the most common type of skin cancer to be reported in our institute, which is similar to the majority of other international studies.

Assessment of the accuracy of death certification at two referral hospitals.

BACKGROUND: Death certification is a vital source of information used in mortality statistics worldwide to assess the health of the general population. This study focuses on the consistency of information between the death reports and the clinical records (files) of deceased patients in two hospitals: the King Khalid University Hospital (KKUH) and King Fahad National Guard hospital (KFNGH) in Saudi Arabia. METHODS: A random sample of the records of 157 deceased patients' registered in 2002 in the two hospitals was retrospectively reviewed independently to determine the underlying cause of death and compare them with death reports. It was also to check the accuracy of the translation from English in to Arabic. RESULTS: It was found that the underlying cause of death was misdiagnosed in 80.3% of the death reports. When the two hospitals were compared, no significant difference was observed (p>0.05). In addition, 81.8% of the accurate (correct) death reports in both hospitals were of patients who had died of a malignant disease. However, the translation of the underlying cause of death in KFNGH was correct in 86.1% of the death reports, while in KKUH it was only 25%, which is highly statistically significant (p<0.0001). CONCLUSION: With the limitation of studying only a small number of cases, these results indicate a discrepancy between the file and death reports in relation to the cause of death. Also, the translation of the cause of death was inconsistent in the two hospitals. Hence, there is a real need to adopt suitable measures to improve the quality of death certification.