ABSTRACT
Introduction Post-operative adhesions present a number of difficulties, including intestinal obstruction and infertility, and they frequently require readmission due to adhesion-related problems. Notwithstanding these ramifications, there are surprisingly few thorough national surveys that address surgeons' awareness of adhesives. By assessing Saudi surgeons' knowledge of post-operative adhesions and their use of anti-adhesive medications, this study aims to close this knowledge gap. Methods This study is a cross-sectional observational research study aimed at Saudi Arabian surgeons utilizing a self-administered, semi-structured online questionnaire. The questionnaire was distributed to participants via social media and in-person email using basic random selection. It included adhesion morbidity and prevalence, pre-operative informed consent issues, adhesion preventive viewpoints, and anti-adhesive chemical use. Results There were 111 participants in total, of 41% were experienced surgeons with more than five years of experience. According to the survey, the majority of surgeons occasionally employed anti-adhesive compounds, especially during laparotomies (28%), and 38% never used them during laparoscopies. The study found that participants varied in what they informed patients regarding adhesion complications: 25% of participants informed 5%-10% of the patients about the possible adhesion complications in laparotomy procedures, whereas 26% of participants informed 10-25% of the patients in laparoscopic procedures. Compared with their specialist peers, general surgeons agreed more on the clinical significance of adhesions and prevention. Notably, three-quarters of participants were unclear about when to use anti-adhesive compounds. Conclusion While acknowledging the clinical significance of post-operative adhesions and recognizing the potential for prevention, most surveyed surgeons did not include adhesions as a post-operative complication in informed consent. The study underscores a belief in the efficacy of anti-adhesives yet reveals a widespread lack of clarity regarding specific indications for their use. Recommendations include implementing educational sessions during surgical training to heighten awareness of adhesions as a major post-operative complication and to encourage the appropriate utilization of available barriers and pharmacological anti-adhesive products.
ABSTRACT
Background Cardiovascular disease is the leading global cause of mortality. Recognition of myocardial infarction (MI) symptoms is crucial as it influences clinical outcomes. Furthermore, awareness of MI risk factors assists in obtaining healthier lifestyles, alleviating its burden and mortality rates. This study aims to evaluate the awareness levels of the general population in Saudi Arabia regarding MI symptoms and risk factors and to identify its determinants. Methods A descriptive cross-sectional study was conducted among the general Saudi population, with 1,247 participants, excluding those residing outside Saudi Arabia and healthcare-related individuals. An online self-administered questionnaire encompassed sociodemographic characteristics, awareness of MI symptoms and risk factors, and participants' perceptions concerning appropriate responses during an MI event. Results The majority of participants recognized chest pain and shortness of breath as MI symptoms, with a percentage of 87.1% and 86%, respectively. Risk factors awareness was substantial at 90.3% for smoking and 76.1% for obesity. The mean overall awareness score was 26.6±7.5, and around 36% were aware of both symptoms and risk factors. Higher education levels were positively associated with both risk factors and symptom awareness, while employment status showed negative associations with both. Higher-income correlated with greater risk factors awareness. Gender remained significant, with males exhibiting a lower awareness of risk factors and symptoms. Region and chronic disease status were positively associated with risk factors and symptom awareness. More than 90% of participants perceived going to the emergency room immediately if they recognized an MI attack. Conclusion This study highlights the necessity for inclusive awareness campaigns to enhance the identification of MI symptoms and risk factors in Saudi Arabia. It should focus on groups with limited awareness, such as males, employed and retired individuals, and specific pronounced regional disparities.
ABSTRACT
INTRODUCTION: The aim of this study was to evaluate the yield of bronchoscopy-guided bronchoalveolar lavage (BAL) and decisions on management of antimicrobials in critically ill patients with hematological malignancy and/or hematological stem cell transplant (HSCT). The safety and tolerance of bronchoscopy were also reported. METHODS: A retrospective cohort study was conducted by reviewing health charts of all adult patients with a hematological malignancy and/or an HSCT who were admitted to the intensive care unit and underwent bronchoscopy and BAL over four years from April 2016 to April 2020 at King Abdulaziz Medical City, Riyadh. Results: The cohort included 75 critically ill patients. Of these 75 patients, 53 (70.7%) had HSCT (allogenic 66%, autologous 32.1%, haplogenic 3.8%). Computed tomography of the chest was abnormal in all patients. Predominant findings included airspace abnormalities, ground glass opacities, and others. The positive yield was found to be 20% for bacterial, 22% for viral, 21% for fungal, and other organisms were identified in 2%. Although cytology was not performed in 18 patients, malignant cells were identified on BAL in two patients. While the overall mortality of the cohort was high (46.7%), the vast majority (94.7%) tolerated bronchoscopy and BAL without any complications. However, three patients (4%) developed a pneumothorax and one patient bled and developed the acute respiratory distress syndrome post bronchoscopy. CONCLUSIONS: BAL can identify and detect microorganisms directly influencing the clinical care of patients who have received non-invasive diagnostic tests that yielded negative culture results. Bronchoscopy and BAL are generally safe and well tolerated by critically ill patients with hematological malignancy or HSCT.