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Background Inpatient dermatological care represents an opportunity to improve dermatological care among the population as well as to enhance clinical exposure for residents and medical trainees. Objective We conducted this study to analyze the pattern of dermatological conditions encountered in inpatient settings and the modalities of management at a tertiary care hospital. Method We retrospectively reviewed and analyzed electronic records of all inpatient consultations carried out by the dermatology consultants and specialists between January 1, 2020 and December 31, 2020. Demographic and specific and non-specific clinical data were collected and analyzed by dividing the skin disorders and treatments into categories, where relevant. Result Five hundred and seventy-one inpatient dermatological consultations were carried out, involving 453 patients. Older age groups were predominant, including 50-70 years (27.4%) and >70 years (21.0%). The female to male ratio was 1.19. The majority of the consultations (388/571, 68.1%) were requested from the adult medical wards; internal medicine (23.8%), hematology (13.7%), and oncology (9.1%) being the most frequented wards. A biopsy was carried out in 57 (10.0%) of the cases. The most prevalent diagnoses included dermatitis (16.3%), intertrigo (8.1%), and xerosis (6.8%). Besides, 10 cases of skin cancer or metastasis were diagnosed by the dermatologist. The diagnosed skin condition was drug-induced in 57 (10.0%) of the cases, and nine of them were due to chemotherapy. Pharmaceutical treatments consisted of more frequently used corticosteroids (51.5%), antibiotics (36.4%), and antifungal agents (20.8%), with the majority of these by topical route. Conclusion A broad range of dermatological conditions are diagnosed in our inpatient setting, representing a good educational opportunity for trainee dermatologists. The implementation of digital photography could enhance the documentation of dermatological conditions, which would have beneficial effects on both care quality and education.
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BACKGROUND: Anesthetists deal with many situations where they decide whether proceeding with anesthesia is safe or not. These are termed "go or no-go" decisions. Although guidelines have been developed to ensure safe anesthesia, many factors affect anesthetists' decision in practice. Therefore, we aimed to assess the variability in risk tolerance when making "go or no-go" decisions among anesthetists in Saudi Arabia. MATERIALS AND METHOD: A questionnaire-based study that included anesthetists practicing in Saudi Arabia from 1--14th October 2017 was conducted. The questionnaire presented 11 clinical scenarios that involved deviation from guidelines, followed by four questions where the participants were asked to decide whether they would proceed with administering anesthesia, write a comment explaining their decision, to predict whether a colleague would make the same decision, and if they had a previous similar experience. RESULTS: A total of 124 anesthetists responded, of which 56.5% were consultants. There was no absolute consensus over the decision to proceed in any scenario. Most of the respondents who would proceed (67.35%) expected a colleague to make the same decision. Anesthetists who encountered a previous similar experience were more likely to proceed (P = 0.000). There was no significant difference among the respondents' decisions according to years of experience (P = 0.121). Analysis of the comments showed that procedure urgency and presence of alternatives to deficient resources were the most frequent factors that dictated anesthetists' decision. CONCLUSION: There is a wide variation in risk tolerance among anesthetists. Further simulation-based studies are needed to identify and address factors that affect anesthetists' decisions.