ObjectivesParticularly in the Middle East, few studies have explored the attitude of cancer patients and their families toward cancer diagnosis disclosure (CDD). This study was conducted to investigate the preference and attitude of a sample of cancer patients and their families in Saudi Arabia toward CDD.MethodsWe constructed a questionnaire based on previous studies. The questionnaire assessed preference and attitude toward CDD. Participants were recruited from the King Abdullah Medical City, which has one of the largest cancer centers in Saudi Arabia.ResultsThree hundred and four cancer patients and 277 of their family members participated in the study. The patient group preferred CDD more than the family group (82.6% vs 75.3%, P<0.05). This preference is especially more evident toward disclosure of detailed cancer information (status, prognosis, and treatment) (83.6% vs 59.9%, P<0.001). In a binary logistic regression, factors associated with preference toward CDD included having information about cancer (odds ratio [OR] 1.8; 95% confidence interval [CI], 1.15–2.84) and being employed (OR, 1.77; 95% CI, 1–2.82) while being from the patient group was the only factor associated with preference toward detailed cancer information (OR, 3.25; 95% CI, 2.11–5.05). In terms of patient reaction after CDD, “fear” was the attitude expected by the family group more than the patient group (56.3% vs 70.4%, P<0.001) while “acceptance” was the attitude anticipated by the patient group more than the family group (38% vs 15.2%, P<0.001).ConclusionPatients preferred CDD and disclosure of related information, while their families were more inclined toward scarce disclosure. Family members seem to experience negative attitudes more than the patients themselves.

Background: Several studies worldwide reported negative attitude toward psychiatry from medical students and interns. Despite the increasing demand for psychiatry and mental health services, psychiatrists' numbers are still low, and the field of psychiatry is still attracting a lower number of medical students. Objective: This study aims to measure the attitude of medical students and interns toward psychiatry in Umm Al-Qura University medical college, Makkah, Saudi Arabia. Method: A Cross-sectional study. A web-based Attitude Toward Psychiatry (ATP-30) questionnaire was distributed among randomly chosen interns and 6th-year medical students, who had completed their psychiatry course and rotation, and to fourth and 5th-year medical students, who did not have any previous exposure to psychiatry. Results: A total of 335 participants completed the survey, of which 168 were males, and 167 were females. Among them, only 53 are considering psychiatry as a career, while 193 did not, and 89 are not sure. The participants showed an overall positive attitude with the mean scoring of 98.09 ±12.22 on the ATP-30 questionnaire, with male participants showing more positive attitude (99.65±11.48) than female participants (96.44±12.79). The most neutral responses were about how facts in psychiatry are just vague speculations, how their undergraduate training in psychiatry was valuable, and that psychiatry cannot be taughteffectively because it is so amorphous. Negative attitude was observed in the areas concerning the choice of psychiatry as a future career and viewing psychiatric hospitals as little more than prisons. Positive attitude toward areas on the validity of psychotherapy, viewing psychiatry as a respected branch of medicine, attention toward mental illness, and the humanity of the mentally ill. Significant differences based on gender were observed in the areas measuring attitude toward psychiatric patients, psychiatric illness, psychiatry, and psychiatrists. The prior exposure to psychiatry teaching and practice did not seem to affect the attitude. Conclusions: Interns and students overall showed neutral to positive ATP. Proper evaluation and subsequent modification to the current

Objective: There is a paucity of research on the factors predicting mortality and a length of stay in the Intensive Care Unit (ICU) with solid tumor patients. This study will assess the characteristics and predictors of outcomes of patients with solid tumors in medical ICU. Material and Methods: This research has been designed as a retrospective observational study using an ICU database. Patients who have a solid tumor were included in the study (May 2015 to July 2018). Post-surgical and those with a length of stay of more than one day are excluded from the study. We identified the predictors     for ICU mortality and ICU long stay (≥21 days). Results: Out of 2883 patients, 364 patients with solid tumors were enrolled. The commonest sites for solid tumors were breast (15.9%), colorectal (11.5%), and lung (9.9%). 158 (43.4%) had metastatic disease, and 264 (72.5%) with progressive disease. The major reasons for ICU admission were a respiratory failure (52.7%) and severe sepsis (52.2%). The ICU and hospital mortality rates were 32.4% and 47%, respectively. Fifty patients (13.7%) had long stayed (≥ 21 days) in ICU. The independent predictors for mortality were Sequential Organ Failure Assessment (SOFA) score (OR, 1.2; 95% CI, 1.1–1.3; P=.000), invasive ventilation (OR, 3.5; 95% CI, 1.5–8.3; P=.004) and vasopressor (OR, 2.6; 95% CI, 1.1–5.9; P=.018), while the independent predictors of long-stay were ICU infections (odds ratio [OR], 18.9; 95% CI, 5.3 – 66.7; P=.0001), SOFA score (OR, 1.5; 95% CI, 1.2–1.8; P=.0001), invasive ventilation (OR, 8.2; 95% CI, 1.6–40.4; P=.009), bilirubin (OR, .5; 95% CI .2–.9; P=.049). Conclusion: Irrespective of the cancer stage, patients had a reasonable survival, and most do not require a long stay in the ICU. Flexibility in admission should be considered as disease progression and metastatic disease were not independent predictors of ICU mortality or long stay in this study.

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Objective:To investigate the incidence of stroke among pilgrims and describe factors associated with presentation and management during Hajj. Physical stress, age and vascular risk factors render pilgrims at a high risk of stroke.Methods:This is a prospective registry of all acute stroke patients admitted to 6 hospitals during the 2015 Hajj season from 9 September to 4 November. Participating hospitals were King Abdullah Medical City (KAMC), Al-Noor, King Abdulaziz hospital, King Faisal hospital, Hira, and Mena general hospitals; all in Makkah city. Stroke diagnosis was confirmed by imaging. Clinical, demographic and outcome variables were collected.Results:The incidence of stroke during 2015 Hajj season is 8.9/100,000; 186 cases. The peak incidence was noted on the day after Arafat. Saudis represented 17.2% while 36% were females. Hemorrhagic stroke occurred in 35 patients (18.8%). The mean age was 60.8±12.9 years while the most common risk factors were hypertension (57%) and diabetes (40.9%). Only 5 patients received intravenous tissue plasminogen activator. The median length of hospital stay was 4 days. Twenty-one patients (11.3%) died during hospitalization. The only factor that approached significance in predicting mortality was hemorrhagic stroke (odds ratio of 1.62; 95% CI: 0.97 to 2.70; p=0.063).Conclusion:Stroke is a major health burden during Hajj. Educational programs for pilgrims and healthcare workers together with protocol-driven care are expected to positively impact stroke care.