Pattern of clinical endocrine practice in King Khalid University Hospital

Background: the endocrine system releases hormones that help control body functions including the body's ability to change calories into energy that powers cells and organs. The endocrine system influences heart beats, bones and tissues growth. It plays an important role in controlling blood glucose. Moreover, it is associated with many disorders including thyroid disorders, growth disorders, and sexual dysfunction. All endocrine glands release hormones into bloodstream

Objective: The objective of this study was to define the types of diseases seen at the only endocrine clinic in King Khalid University Hospital [KKUH]

Methods: we retrospectively analyzed the diagnosis data of all patients attending the endocrinology clinic of the University Hospital in AL Riyadh city over a 7 weeks' period

Results: The majority of cases had thyroid related diseases [48.6%] while 12.8% had gonadal and growth diseases, 9.2% had Lipid, 7.3% had pituitary diseases, 5.5% were for wrong referrals, 5.5% and 4.9% had adrenal and vitamin D deficiency related diseases respectively. The lowest percentages were 3.7% for parathyroid and 2.8% for metabolic bone diseases

Conclusion: Thyroid related disorders were found to be the most common endocrine disorders presented to KKUH. Almost half of the patients had thyroid related disorders, accordingly we highly recommend that extensive efforts should be in place to recruit experienced residents as well as continuously and efficiently train existing ones on Thyroid related diseases

Knowledge, opinions and attitude of surgeons in Saudi Arabia toward informed surgical consent

Background: Informed consent has become a vital factor for the clinical treatment of modern practice in the medical field, it is participating in legal, ethical and administrative compliance side. However, informed consent is variably applicable and rarely fulfills its theoretical ideal. Disclosure of adequate information is very important before signing informed consent. It is important to make patient enable to take a proper decision with good knowledge about his/her case. Informed consent for the surgical procedure is consent that taken from the patient before surgical operations and invasive procedures after explaining advantages and disadvantages. Getting patient's signature for the consent of operations and the surgical procedure is surgeon's job. The opinion of the surgeon about informed consent is important, as that may affect the performance of surgeon in explaining procedure with its risks and benefits

Aim: Assessment of knowledge, opinion, and attitude of surgeons towards informed consents. Find out how to improve the quality of informed consent from surgeons' suggestions

Method: This cross-sectional study is questionnaire-based study. Our target was to reach many surgeons in Saudi Arabia with different specialties, different status and from different hospitals. We take our sample using random sampling technique. We selected surgeons from each hospital that our data collector can reach and enter easily. Collection of data was done by interview. Our questionnaire contained four parts in addition to demographic data part. The first part was asking about surgeons' opinions regarding informed surgical consent process. The second part was responsible for inquire about obtaining informed surgical consent. The third part is about the refusal to sign informed surgical consent. Last part is to ask about surgeons' suggestions to improve informed surgical consent

Result: Total number of respondents was 140 [Response rate is 93.3%]. Around 34% of participants agreed that surgeons don't give adequate information about the surgical procedure. 33.6% insisted to know about their surgery. After asking each surgeon about the importance of informed surgical consent they selected the following answers in descending order; informing patients about advantages, hazards and alternatives [81.4%], Medico-legal importance [79.3%], decision taking about procedure [72.1%], hospital policy [50.7%] and surgical tradition [19.3%]. Most of the doctors [85%] complained that sometimes, their patients refused to sign consent. Fear was the most common cause of singing consent refusal according to opinions of 62.9% of surgeons

Conclusion: Surgeons in Saudi Arabia have acceptable knowledge about informed surgical consent and how to obtain it. But still there were some opinions of surgeons opposite to what is practiced, and also some of them practiced something not ideal while obtaining informed surgical consents. However, most of the surgeons know the importance of consent and what is important to be disclosed in it. In general, the frequency of consent refusal was low

Chronic hepatitis C treatment: a systematic review

Background: Chronic hepatitis C [CHC] infection affects almost 3% of the global population and can lead to cirrhosis, liver failure, and hepatocellular carcinoma in a significant number of those infected. Thus, there is a compelling need to develop and introduce new therapeutics with a direct-acting antiviral effect in order to target various stages of the HCV lifecycle for HCV eradication without concomitant interferon

Study Objective: to provide treatment recommendations for chronic HCV for specialists and generalists based on published evidence

Methods: A literature search of Web of Science, Scopus, Embase, Agricola, Cochrane Library, Cinahl Plus, Google Scholar, and Oaister was conducted from 1990 to 2016, records were filtered according to the Inclusion criteria and 27 hits were yielded

Results: Hepatitis C virus genotype 1 is more difficult to cure than genotype 2 or genotype 3. Patients with HCV genotype 1 should receive treatment with sofosbuvir + pegylated interferon + ribavirin because of the shorter duration of therapy and high rates of SVR [89%-90%]. Simeprevir + pegylated interferon + ribavirin is an alternative for patients with HCV genotype 1 [SVR, 79%-86%]. Patients with HCV genotypes 2 and 3 should receive therapy with sofosbuvir + ribavirin alone [SVR for genotype 2, 12 weeks' duration: 82%-93%; SVR for genotype 3, 24 weeks' duration, 80%-95%]. Patients with HIV-HCV coinfection and patients with compensated cirrhosis [ie, cirrhosis but preserved synthetic liver function] should receive the same treatment as HCV-monoinfected patients

Conclusion: A growing body of evidence suggests that recently developed HCV combined treatment modalities have transformed chronic HCV into a routinely curable disease being relatively available and well tolerated,which can potentially reduce the need for liver transplantation and reduce HCV-related mortality. Treatment protocol for genotype1 is based on a combined regimen of Pegylated interferons with ribavirin and sofosbuvir or simeprevir while Sofosbuvir with ribavirin alone should be used to treat patients infected with HCV genotypes 2 and 3. Patients coinfected with human immunodefiency virus and HCV genotype 1 should be treated for HCV with pegylated interferons, ribavirin, and sofosbuvir by a physician with experience in treating this particular group of patients and familiar with potential drug interactions