Journal of Health Specialties最新文献

{"title":"Physicians' perceptions of breaking bad news to cancer patients and family","authors":"S. Alshammary, A. Hamdan, Lobna A. Saleem, S. Ratnapalan, B. Duraisamy","doi":"10.4103/JHS.JHS_57_17","DOIUrl":"https://doi.org/10.4103/JHS.JHS_57_17","url":null,"abstract":"Background: Breaking bad news to patients with a cancer diagnosis is not an easy task for physicians. The diagnosis must be explicitly stated and understood, and the prognosis must be well-discussed in the most gentle and comfortable manner. It is important that the disclosure is performed in a way that patients will not lose all hope and get very depressed and undergo an abrupt change in their outlook on life. Objective: The aim of this study was to explore physicians' perceptions and perspectives of breaking the bad news to cancer patients before and after attending training workshops. Methods and Settings: A quasi-experimental design was performed among physicians working in a comprehensive cancer centre. It compared the performance of the respondents in breaking bad news before and after attending a communication skill workshop. It was conducted from March to April 2017. Results: Pre-intervention survey result showed 68% responded to the survey. Eighty-four percent were comfortable with breaking bad news, and 70% had training in breaking bad news. Eighty-six percent of the responders (86.3%) stated that patients should be told about their cancer. Almost 30% of the respondents stated that they would still disclose the diagnosis to patients even if it would be against the preference of the relatives. Nearly 61% said that they would only tell the details to the patients if asked. Nearly 67% of them disagreed that patients should be told about the diagnoses only if the relatives consent. About 51% of physicians wanted to discuss the bad news with the family and patient together, whereas 24% stated that the patient alone should be involved in the discussion. Conclusion: Physicians face a dilemma when families do not wish the patient to know about the cancer diagnosis, and this highlights the necessity of taking into consideration the social circumstances in healthcare. When taking these into consideration, curriculum in the medical school must, therefore, be updated and must integrate the acquisition of skills in breaking bad news early in training.","PeriodicalId":31033,"journal":{"name":"Journal of Health Specialties","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84095414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Schistosomal appendicitis presenting as acute peritonitis: A case report and literature review","authors":"M. Aldossary, Fatimah Almabyouq, M. Mashhour, K. Hassan","doi":"10.4103/JHS.JHS_35_17","DOIUrl":"https://doi.org/10.4103/JHS.JHS_35_17","url":null,"abstract":"Schistosomiasis is the third most devastating tropical disease in the world. According to a literature review, there have been a few reports of peritonitis due to schistosomiasis. Here, we report a rare case of schistosomal appendicitis presenting as acute peritonitis.","PeriodicalId":31033,"journal":{"name":"Journal of Health Specialties","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78335520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and predictors of adverse events and outcomes for adult critically ill patients transferred by paramedics to a tertiary care medical facility","authors":"Abdullah Alabdali, C. Trivedy, Nawfal Aljerian, P. Kimani, R. Lilford","doi":"10.4103/JHS.JHS_19_17","DOIUrl":"https://doi.org/10.4103/JHS.JHS_19_17","url":null,"abstract":"Objective: The aim of this study was to determine the incidence of adverse events and patients' outcomes in inter-facility critical care transfers by paramedics. Methods: We conducted a retrospective cohort study of adults undergoing inter-facility transfer to a tertiary medical facility by paramedics. We included all patients transferred between 1st June, 2011 and 31st December, 2014. The primary outcome is in-transit adverse event and the secondary outcome is in-hospital mortality. Multiple logistic regression models were fitted to assess predictor variables for adverse events and in-hospital mortality. Results: The incidence of adverse events was 13.7% (31/227 patients had in-transit adverse event); the most common adverse events reported were desaturation and hypotension. A unit increase in risk score for transported patients (RSTP) significantly increased the occurrence of adverse events (adjusted odds ratio [OR]: 1.36, 95% confidence interval [CI]: 1.07–1.72 and adjusted P = 0.01). Compared to medical patients, cardiac patients were less likely to develop adverse events (adjusted OR: 0.117, 95% CI: 0.02–0.52 and adjusted P < 0.01). The in-hospital mortality was 30.4% and 30-day survival was 68.1%. For two patients whose age differed by 1 year, the older patient was more likely to die (adjusted OR: 1.03, 95% CI: 1.01–1.05 and P < 0.01) and a unit increase in RSTP significantly increased occurrence of in-hospital mortality (adjusted OR: 1.30, 95% CI: 1.0–1.60 and P = 0.01). Conclusion: The incidence of adverse events was 13.7%. The most common observed adverse events were desaturation and hypotension. In-hospital mortality was 30.4% and 30-day survival was 68.1%.","PeriodicalId":31033,"journal":{"name":"Journal of Health Specialties","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82965996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proportions of major comorbid medical conditions among psoriasis patients in a tertiary hospital, Riyadh","authors":"S. Hassan, Althomali A Waleed, O. Abdullah, O. A. H. Rana","doi":"10.4103/JHS.JHS_136_16","DOIUrl":"https://doi.org/10.4103/JHS.JHS_136_16","url":null,"abstract":"Background: Psoriasis is a chronic inflammatory skin disease that is related to immunological, genetic and environmental factors. It has been recognised as a multisystemic disorder with an increased risk of developing extracutaneous manifestations. Aim: This study aims to explore the distribution and proportion of major comorbidities among psoriatic patients of King Abdulaziz Medical City (KAMC). Methods: A case series study was conducted in KAMC in Riyadh. It targeted psoriatic patients of all age groups from both genders. Data were collected by retrieving psoriatic patients' medical files to acquire age, gender, weight, blood pressure and different laboratory profiles from their charts.Results: A total of 81 psoriatic patients were included (45 males, 36 females). The mean age was 50 ± 20 years. The proportion of psoriatic patients having hypertension was found to be 48% (n = 39). Diabetes and dyslipidaemia were found among 65% (n = 53) and 62% (n = 50) of psoriatic patients, respectively. Body mass index screening showed 56 (69%) psoriatic patients to be either overweight or obese. Conclusion: Medical comorbidities including hypertension, diabetes and dyslipidaemia were found in high proportions in patients with psoriasis. These findings indicate the necessity to closely control and monitor comorbid disorders among these patients.","PeriodicalId":31033,"journal":{"name":"Journal of Health Specialties","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77458974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, attitude and intention towards nursing profession among pre-clinical students","authors":"W. Hatamleh, Erik Hans L Sorio","doi":"10.4103/JHS.JHS_154_16","DOIUrl":"https://doi.org/10.4103/JHS.JHS_154_16","url":null,"abstract":"Context: In Saudi Arabia, there is still an insufficient supply of nursing graduates to meet the growing demand for nurses to provide patient care. Aims: The aim of this study was to further investigate on the knowledge, attitude and intention towards nursing profession among pre-clinical students. Settings and Design: A descriptive-correlational design was used in this study with a total of 128 pre-clinical male and female students from a nursing school in Riyadh. Subjects and Methods: Data were obtained using an adopted survey instrument for describing the knowledge, attitude and intention among the participants. In the last two parts of the instrument, the participants answered the questions using 5-point Likert scale. Statistical Analysis Used: Data were analysed using SPSS version 20.0. Descriptive statistics was utilised to describe the variables and Chi-square to show correlation between variables. Results: In general, the participants had good knowledge of the nursing profession and a majority of the students disagreed that nursing is a job for females only. However, about 60% of the participants were not interested to study nursing. Conclusions: The findings concluded that working with the opposite sex and people not respecting the nursing profession were found to have the highest influence in preventing the students from becoming a nurse. Moreover, positive attitude towards nursing would significantly result in students becoming more interested to the profession.","PeriodicalId":31033,"journal":{"name":"Journal of Health Specialties","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84227520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Faculty perspective on competency-based research education: A multi-centre study from Saudi Arabia","authors":"Hamzah A. Naji, Jumana Sarraj, I. Muhsen, S. Kherallah, Ahmed S. Qannita, Akef S. Obeidat, M. Sajid","doi":"10.4103/JHS.JHS_145_16","DOIUrl":"https://doi.org/10.4103/JHS.JHS_145_16","url":null,"abstract":"Introduction: Research is becoming indispensable in today's medical education and clinical practice. Engaging medical students in research activities and producing clinically competent and research-oriented medical students are essential demands of today's modern medicine. Incorporating research-based competencies and designing research-oriented medical curricula are challenging and need more attention, especially in developing countries. The aim of this study was to identify research competencies for medical students and the best instructional modality for their integration in the medical curricula. Methodology: A list of research competencies needed to be acquired by medical students during their undergraduate level have been proposed and classified under the following categories: general research skills, biostatistics, basic biomedical research and clinical research and epidemiology. The competencies were further reviewed by academicians of different fields. Afterwards, a questionnaire was prepared targeting researchers who have mentored undergraduate medical students in Riyadh, Saudi Arabia. Research mentors were asked to rate the importance of the competencies listed using a 5-point Likert scale and to determine how they should be delivered into the medical curricula. Results: Results showed that Likert scale mean score ranged from 3.44 to 4.71, illustrating mentors' agreement to the importance of the competencies listed. Around 52% and 58% of mentors choose 'compulsory component' in case of 'general research skills' and 'biostatistics', respectively. On the other hand, 75% and 66% of mentors choose 'non-compulsory component' in case of 'basic research' and 'clinical research and epidemiology', respectively. Conclusion: Standardisation of competencies might help to better integrate research competencies in medical curricula.","PeriodicalId":31033,"journal":{"name":"Journal of Health Specialties","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87507146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge and awareness on personalised medicine amongst medical students: A cross-sectional survey","authors":"Sarah Altayyari, Anoud R. Omer, H. Aljifri, Bashair Magadmi, Amira Nemri, M. Basheikh, A. Sindi","doi":"10.4103/2468-6360.210429","DOIUrl":"https://doi.org/10.4103/2468-6360.210429","url":null,"abstract":"Introduction: Personalized medicine is the field that utilises patients' genetic and environmental data in order to deliver optimal healthcare, and since it is a rapidly evolving area and is currently incorporated in several health care systems, this study was conducted to assess the knowledge and awareness about personalized medicine among medical students in Saudi Arabia. Methods: A sample of medical students from the King Abdulaziz University Hospital were selected for this study and interviewed using a validated self-administered questionnaire. Results: 534 students participated in the study, 324 (60.7%) acknowledged to having heard of personalized medicine, yet only 42 (7.9%) self-scored their level of knowledge about personalized medicine at “extremely knowledgeable”. About one-third of the participants showed high interest in genetic testing personally, and the other applications of personalized medicine. On an academic note, 437 (81.8%) were interested in attending rotations and rounds focusing primarily on personalized medicine. Conclusion: Participants demonstrated genuine interest in personalized medicine; however, more focus on this field should be introduced into the medical curricula. There is a need to conduct more national surveys to assess the level of awareness among health professionals and the general population in Saudi Arabia regarding personalised medicine.","PeriodicalId":31033,"journal":{"name":"Journal of Health Specialties","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80177791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The commission in 2020: A transformation journey worth taking!","authors":"A. Abdo, M. Bodrick","doi":"10.4103/JHS.JHS_56_17","DOIUrl":"https://doi.org/10.4103/JHS.JHS_56_17","url":null,"abstract":"","PeriodicalId":31033,"journal":{"name":"Journal of Health Specialties","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90157291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of levofloxacin-doxycycline-based rescue therapy for Helicobacter pylori eradication: A prospective open-label trial in Saudi Arabia","authors":"F. Alsohaibani, Sarah A. Alharfi, M. Almadi","doi":"10.4103/JHS.JHS_158_16","DOIUrl":"https://doi.org/10.4103/JHS.JHS_158_16","url":null,"abstract":"Background: Helicobacter pylori eradication is achieved in 60%–80% with first-line therapy. Different second-line therapeutic options are available. However, the success of second-line therapy has not been addressed or reported from Saudi Arabia. Objectives: The primary objective was to evaluate the efficacy of the 10-day course of levofloxacin, doxycycline and esomeprazole in non-responders to first-line therapies for H. pylori eradication in Saudi Arabia. Secondary objectives included were symptoms' response to treatment, factors associated with eradication of H. pylori and adverse events associated with the treatment. Patients and Methods: A prospective, open-label, single-arm study was conducted. Patients were recruited from a tertiary care hospital in Saudi Arabia from June 2013 to April 2014. A total of 55 patients had previously received standard triple therapy and/or sequential therapy from 2011 to 2014 and failed to eradicate the infection. The rescue treatment was given for 10 days consisting of levofloxacin 500 mg once daily, doxycycline 100 mg twice daily and esomeprazole 20 mg twice daily. Urea breath test (UBT) was done at a minimum of 6 weeks after completion of the treatment to confirm the H. pylori eradication. Results: From 55 patients recruited, 32 had failed to respond to previous standard triple therapy, 15 patients failed to respond to sequential therapy and 8 patients failed to both regimens. Persistent H. pylori infection was confirmed by rapid urease test, histology or UBT. H. pylori eradication was achieved in 20 out of 51 patients (39.22%, per protocol analysis, 36.36% by intention to treat analysis). Therapy was well tolerated and side effects were generally mild. Conclusion: Rescue treatment with levofloxacin and doxycycline-based therapy for 10 days was well tolerated but effective only in 39.22% of patients infected with H. pylori in Saudi Arabia. More trials to determine the most efficacious rescue therapy in Saudi Arabia are needed.","PeriodicalId":31033,"journal":{"name":"Journal of Health Specialties","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80327944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paediatric emergency department during the holidays: Findings from a 10-year analysis of visit rates and trauma patterns","authors":"F. Alhusain, Nada Alhassan, Wijdan AlJohi, F. I. Alrumaih, Nawfal Al Jerian, N. Alharthy","doi":"10.4103/JHS.JHS_169_16","DOIUrl":"https://doi.org/10.4103/JHS.JHS_169_16","url":null,"abstract":"Context: It has been observed that emergency department (ED) visits have been continuously increasing globally and that certain days might affect ED visits and trauma patterns. In previous literature, there is controversy regarding the correlation between paediatric ED (PED) visits and holidays. Aims: To identify the impact of holidays on overall PED visits, trauma rates and characteristics. Settings and Design: This is a retrospective time-series analysis of PED visits and paediatric trauma from 2004 to 2013 conducted in King Abdul-Aziz Medical City, Riyadh, Saudi Arabia. Subjects and Methods: We extracted all ED visits during the 10-year period and included all trauma-related visits recorded in the paediatric trauma registry. The days were marked as holidays or non-holidays. Statistical Analysis Used: SAS Ver. 9.3 was used for analysis. Chi-square test and negative binomial regression were used. Significance was declared at P< 0.05. Results: Holidays were associated with decreased PED visits by 13% compared to non-holidays. Paediatric trauma increased during the holidays by 30%. The highest decrease of PED visits was observed during the summer by 32%. By contrast, during the summer, there was a 56% increase in trauma rates. In Eid A-Fitr, all PED visits decreased by 28%, whereas paediatric trauma increased by 70%. Time of trauma arrival, mechanism of injury, Injury Severity Score and Glasgow coma scale changed significantly during the holidays. Conclusions: Holidays appear to be associated with higher rates of paediatric trauma and fewer overall PED visits. Future work could focus on exploring the reasons behind this change and potential counter measures.","PeriodicalId":31033,"journal":{"name":"Journal of Health Specialties","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78934332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}