Background and objectiveLabor pain is one of the most severe forms of pain that women experience throughout their lifetime. Many pregnant women decide to have an epidural anesthesia to cope with labor pain. This study has focused on general awareness about epidural anesthesia among pregnant women in Jeddah, Saudi Arabia.MethodsThis was a cross-sectional hospital-based study using a self-administered questionnaire, conducted in King Faisal Specialist Hospital and Research Center and International Medical Centre. The study was carried out from July to September 2016 and included all pregnant women who were having a routine antenatal care. They were asked about four main topics that tapped their knowledge on epidural anesthesia. A total of 384 questionnaires were returned and analyzed. Data were analyzed by SPSS version 21 using chi-square and multivariate logistic regression.ResultsAccording to multivariate logistic regression, women aged between 21–35 years were more likely to opt for an epidural anesthesia (EPA) than those aged less than 20 years, but women aged >35 years were less likely to select EPA, compared with women < 20 years old. Women who were previously exposed to EPA were 2.14 times more likely to prefer EPA during their current pregnancy than those who were not previously exposed (O.R 95% C.I: 1.123–3.66, p=0.006). Those who believed that EPA was commonly used by other women in the Kingdom were also 1.41 times more likely to report their preference to EPA (O.R 95% C.I: 1.15–1.74, p=0.001).ConclusionThis study demonstrates a lack of knowledge about EPA in certain countries but is better than in some other countries. In an aim to fill this gap, it is recommended that information about EPA must be given to all women during the antenatal visit either by the obstetrician, anesthetist, or through flyers and brochures.
Necrotizing fasciitis is a life-threatening aggressive soft tissue infection which usually affects the extremities, abdominal wall, or perineum. Breasts are rarely affected, with most cases presenting after trauma or surgical intervention. It may be misdiagnosed as abscess or cellulitis, leading to treatment delays. Here, we report a case of necrotizing fasciitis affecting both breasts in a 60-year-old female. Treatment included core biopsy managed with intravenous antibiotic and surgical debridement followed by a simple mastectomy. Currently, the patient is disease-free with a completely healed wound.
Embryonal Rhabdomyosarcoma ‘Botryoid Type’ is a rare soft tissue tumor that arises within the wall of the bladder or vagina and seen almost exclusively in infants. Treatment is combination of surgery with adjuvants chemotherapy and radiotherapy. We report a case of an 18-month-old Saudi girl presented with history of abdo-pelvic mass, bleeding per vagina and a mass protruding through the introitus. Computed tomography (CT) done reveling large heterogeneous pelvic mass arising from the uterus, biopsy of mass confirmed the diagnosis (sarcomabotryoidal). The patient received multiple cycles of combination chemotherapy as a neoadjuvant treatment then underwent total abdominal hysterectomy with upper vaginectomy. Postoperatively, the patient received more cycles of chemotherapy. CT scan for post-treatment evaluation was done and showed no evidence of local recurrence or distant metastasis. Currently, she is disease-free on remission with no complains.
Background: This study investigates leadership skills and Canadian Medical Education Directives for Specialists (CanMEDS) competencies acquisition within the General Surgery Residency Training Program (GSRTP). The Saudi Commission for Health Specialties (SCFHS) incorporates the CanMEDS Competency Framework into its curriculum to prepare the resident for healthcare needs. Methods: This is a descriptive-analytical study. A questionnaire was used to collect data from 117 General Surgery residents (GS) at seven institutes in Jeddah, Saudi Arabia. Results: The GS residents reported an acceptable self-perceived level of Clinical Leadership Skills (mean ± standard deviation). The most dominant skill was working with others (1.98 ± 1.03), followed by demonstrating personal qualities (2.07 ± 0.88), the ability to manage services (2.21 ± 1.37), improving services (2.22 ± 1.84) and last, setting directions (2.39 ± 0.95). Regarding the CanMEDS competencies, the respondents showed a generally positive perception with an “agree” level (Mean = 1.83). Of the CanMEDS competency roles, Collaborator ranked first followed by Professional and then Communicator. Leader competency ranked fourth followed by Health Advocate, Medical Expert and last, Scholar. Conclusion: The GSRTP residents showed satisfactory self-assessed clinical leadership skills and acquirement of the CanMEDS competencies during their training, which will prepare them to lead in the future.
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