Consequences of COVID-19 Pandemic on Orthopedic Residents' Clinical and Academic Performance, and the Subsequent Impact on Their Mental Status in Saudi Arabia.

Introduction: Impact of COVID-19 pandemic on the orthopedic residency programs was substantial worldwide. Orthopedic residency programs eventually survived such a hardship with implementation of certain measures. The impact of COVID-19 pandemic on the orthopedic trainees was variable relative to the country in which orthopedic residency program is based. This study aimed to assess the experience of the orthopedic residents during COVID-19 pandemic in Saudi Arabia and consequences on mental health, academic performance, and clinical training. Methods: A cross-sectional study was conducted from June 2021 to August 2021. An online survey was sent to the orthopedic residents in Saudi Arabia. The questionnaire was arranged into four sections pertaining to demographic data, academic activity, mental health, and clinical activity. Results: One-hundred forty-four orthopedic residents participated with mean age of 28.7 ± 5.67 years. Males were 108 (75%) and females were 36 (25%). Fifty-four (37.5%) residents worked in COVID-19 isolation unit. One-hundred twenty residents (83.3%) treated COVID-19 patients. Thirty residents (20.8%) had positive COVID-19 tests. Eighty-four (58.3%) residents were quarantined. Overall online education was difficult (41%). Half of the participants faced online difficulties in technicality, maintaining attention, and interaction with audience and examiners. Prospective research conduction was difficult (71.4%). More than 50% of residents experienced difficulties with isolation, quarantine, socialization, and anxiety of disease transmission. Physical examination was difficult for 50% of trainees. No shortage of PPE supply was reported. Getting hands-on surgical training was very difficult (47.8%). Conclusion: COVID-19 pandemic had an adverse impact on Saudi orthopedic residents in terms of academic performance, mental wellbeing, and clinical training. After all, adequate level of orthopedic training quality was maintained. In crises, collaborative efforts are needed to minimize undesirable consequences on the trainees' competency level. Residency program decision makers should utilize all available strategies to optimize the training environment to achieve the required competency level.

High Prevalence of Bone Marrow Involvement and Advanced Disease in Saudi Patients Diagnosed With Hodgkin Lymphoma.

Objectives To estimate the current prevalence of bone marrow involvement in classical Hodgkin lymphoma (HL) patients diagnosed at King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia. Methods A cross-sectional study was conducted among classical Hodgkin's lymphoma patients, diagnosed between 2015 and 2021 at KKUH. We retrospectively collected clinical and pathological information from all adult patients aged 18 years or older with a diagnosis of HL. Survival analyses were performed using the log-rank test and Kaplan-Meier curves. Results The study included 140 patients, 60 (42.86%) of whom were female. Bone marrow involvement was seen in 15 (10.71%) patients, 58 (41.43%) patients had an advanced-stage disease, and 20 (14.29%) patients had gastrointestinal involvement. Patients with bone marrow involvement had a median survival of 71 months (95% confidence interval (CI): 16.7-125.3) compared to patients without bone marrow involvement who had a median survival of 68 months (95% CI: 50.7-85.3). Conclusion The prevalence of bone marrow involvement in HL patients, as well as the proportion of patients presenting with advanced disease at the time of diagnosis, was higher compared to Western data. This could be attributed to a delay in diagnosis or more aggressive disease biology.