Cerebral venous sinus thrombosis in Saudi Arabia.

OBJECTIVE: To analyze the clinical patterns, etiologies, treatment, and outcome of cerebral venous sinus thrombosis (CVST) in 2 major cities of Saudi Arabia, Jeddah and Al-Baha. METHODS: One hundred and eleven patients diagnosed as CVST were identified from the medical records at King Abdulaziz Medical City, Jeddah, and King Fahad Hospital, Al-Baha, Saudi Arabia, from January 1990 through November 2010. We retrospectively analyzed the data, compared it with local and international studies, and reviewed the literature. RESULTS: There were 92 adults and 19 children. Among adults, females predominated, while more boys were affected than girls. The mean age of onset was 29.5 years. The most common clinical presentations were headache, focal neurologic deficits, seizures, papilledema, and decreased level of consciousness. The main risk factors identified were pregnancy/ puerperium, antiphospholipid antibody syndrome, oral contraceptive pills, malignancy, and infections. Multiple sinuses were affected in 51 patients (45.9%). When a single sinus was involved, the superior sagittal sinus (24.3%) was the most common. Seventy-four patients recovered completely, 23 patients recovered partially, and 10 patients died. Bad prognostic factors included incurable co-morbid conditions, late presentation, and status epilepticus. CONCLUSION: Pregnancy/puerperium was the most common etiological factor in our series. Clinical features were similar to international series. Behcet`s disease was not a major etiological factor in our series. Most patients had involvement of multiple sinuses. Prompt treatment with anticoagulation resulted in complete or partial recovery in 87.4% of patients.

The effect of nurse-patient language barrier on patients' satisfaction.

OBJECTIVE: To study Saudi patients' perception of nursing care delivered by non-Arabic speaking nurses (NASNs). METHODS: A cross-sectional survey of randomly selected patients admitted to King Abdul-Aziz Medical City, Riyadh, Saudi Arabia during the summer of 2009. We conducted structured face-to-face interviews, and the Institutional Review Board approved the study. RESULTS: We interviewed 116 patients with a 100% response rate. The mean age was 48 years and 47% were men. Half was illiterate or had a low level of education. Eighty percent was served by NASNs. Most believed that the Arabic language is important to provide high quality of care. Two thirds reported difficulties in understanding nursing instructions, and felt that NASNs could not understand their concerns on many occasions. Half believed that NASNs are more susceptible to error. Seventy percent felt uncomfortable dealing with a nurse who cannot communicate in the same language, and 30% question the reliability of information delivered by NASNs. Patients noticed that NASN avoid (50%) or end conversation (70%) due to language barriers. Sixty-one percent reported that NASNs never or rarely called the interpreter. Overall satisfaction of nursing care was high (90%), with no significant difference between patients who were served by Arabic versus NASNs. CONCLUSION: Our patients were concerned about the language barrier during nursing care delivery. It may lead to miscommunication and compromise the patient-nurse relationship. Further exploration of this issue is recommended.