Factors influencing the selection criteria of Saudi board orthopedic surgery applicants: a national survey of program directors.

BACKGROUND: Annually, medical students vie to secure a seat with an orthopedic residency program. This rigorous competition places orthopedic surgery as one of the most competitive specialties in the medical field. Although several international studies have been published regarding the factors that influence program directors when choosing their ideal applicant, the data for Saudi Arabia in that regard is absent. METHODS: In this cross-sectional study, we aimed to survey all orthopedic program directors regarding the factors that influence them when choosing their ideal orthopedic surgery applicant. A survey was sent to all program directors via email during the month of August 2022. A reminder was sent 2 weeks later to maximize the response rate. The survey was completed by 22 out of 36 orthopedic program directors, which gave us a response rate of 61.11%. RESULTS: In this study, 22 orthopedic surgery program directors responded to our survey. When program directors were asked to rank the factors of residency selection criteria, the top ranked factors were good impression on interviews; prior experience in orthopedic surgery with, for example, electives; and performance on ethical questions during interviews, with means of 9.18, 8.95, and 8.82 out of 10, respectively. Furthermore, program directors preferred letters of recommendation from recommenders that they personally know, clinical experience such as electives taken at the program director's institution, and the quality of publications as the most important aspects of research. Most program directors (90.9%) relied on their residents' and fellows' opinions when selecting candidates, and 77.3% did not think gender has an influence on selection of applicants. CONCLUSION: By providing comprehensive data regarding the factors that influence and attract program directors of orthopedic surgery when choosing residency candidates. With the data provided by this study, applicants for orthopedic surgery have the advantage of early planning to build a strong application that may help persuade program directors to choose them.

Surgical management of a recurrent hydatid cyst in the thoracic spine of a postpartum patient with paraplegia: a rare case report and literature review.

Background: Hydatid disease is a health problem caused by Echinococcus granulosis. Spinal hydatidosis is relatively uncommon when compared to hydatid disease of visceral organs, such as the liver. Case Description: This report details the case of a 26-year-old female who presented acutely with incomplete paraplegia following delivery via cesarean section. She was previously treated for visceral and thoracic spine hydatid cyst disease. On magnetic resonance imaging (MRI), a cystic lesion suggestive of hydatid cyst disease was identified as causing severe cord compression, mainly at T7, raising suspicions of recurrence. Emergency decompression of the thoracic spinal cord via costotransversectomy was performed, as well as the removal of a hydatid cyst and instrumentation from T3-T10. Histopathology findings were consistent with a parasitic infection, specifically Echinococcus granulosis. The patient was administered albendazole for treatment and subsequently had full neurological recovery at the final follow-up. Conclusions: Diagnosis and treatment of spinal hydatid disease is challenging. Surgical excision of the cyst for neural decompression and pathological identification of the cyst is the initial treatment of choice, alongside albendazole chemotherapy. In this review, we have analyzed spine cases reported in the literature and present the surgical approach applied to our case, which was the first reported case of spine hydatid cyst disease following delivery and recurrence. Uneventful surgery, avoiding cyst rupture, and treatment with antiparasitic medication are the mainstays of spine hydatid cyst management and avoidance of recurrence.

Prevalence and Predictors of Scoliosis and Back Pain in 591 Adolescents: A Randomized, Stratified, Cross-Sectional Study in Riyadh, Saudi Arabia.

Purpose Owing to the difficulty of establishing a screening program for scoliosis and back pain, along with their disabling consequences and the lack of local prevalence rates, we sought to study the prevalence of scoliosis and back pain in adolescents in Saudi Arabia and the burden reported by the affected age group on the health system. Materials and methods A school-based, cross-sectional pilot study covering all school districts in Riyadh, Saudi Arabia, was conducted. Students between 12 and 18 years of age were included. Students with any spinal or neurological disorders were excluded. Physical examinations to screen for scoliosis and student-filled questionnaires to assess back pain and health-related quality of life were performed. Results Of the 700 students, 591 met the inclusion criteria. High suspicion of adolescent idiopathic scoliosis (AIS) was considered in 174 students (29.44%). In addition, 45.42% of the students had a history of back pain. The Oswestry Disability Index showed that 87 students had disabilities. The average Scoliosis Research Society-22 score was 3 out of 5. A significant difference was found in the self-image and mental health domains for AIS (p = 0.04, p = 0.02, respectively). Age showed a significant increase in the odds ratio of a positive physical exam for every increase of one year in age (p < 0.01). Conclusion Identifying the prevalence rates and early associated factors during adolescence would help lower the burden on the health system and benefit public health in general. A nationwide study is required to identify the relationship between scoliosis and back pain.

Long-term compliance with continuous positive airway pressure in Saudi patients with obstructive sleep apnea. A prospective cohort study.

OBJECTIVES: To evaluate continuous positive airway pressure (CPAP) compliance and define predictors of CPAP compliance among Saudi patients with obstructive sleep apnea (OSA) after applying an educational program.  METHODS: This prospective cohort study included consecutive patients diagnosed to have OSA based on polysomnography between January 2012 and January 2014 in King Saud University, Riyadh, Kingdom of Saudi Arabia. All patients had educational sessions on OSA and CPAP therapy before sleep study, and formal hands-on training on CPAP machines on day one, day 7, and day 14 after diagnosis. The follow-up in the clinic was carried out at one, 4, and 10 months after initiating CPAP therapy. Continuous positive airway pressure compliance was assessed objectively. Logistic regression model was used to assess the predictors of CPAP adherence. RESULTS: The study comprised 156 patients with a mean age of 51.9±12.1 years, body mass index of 38.4±10.6 kg/m2, and apnea hypopnea index of 63.7±39.3 events/hour. All patients were using CPAP at month one, 89.7% at month 4, and 83% at month 10. The persistence of CPAP-related side effects and comorbid bronchial asthma remained as independent predictors of CPAP compliance at the end of the study. CONCLUSION: With intensive education, support, and close monitoring, more than 80% of Saudi patients with OSA continued to use CPAP after 10 months of initiating CPAP therapy.