Prevalence and characteristics of abnormal papanicolaou smear in central Saudi Arabia

To assess the prevalence and characteristics of abnormal pap smear in the central region of Saudi Arabia. In this retrospective case control study conducted in the Departments of Obstetrics and Gynecology, and Histopathology at King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia, all pap smears screened for Saudi women between 2008 and 2011 were reviewed. Approximately 5000 pap smears are screened annually at King Abdulaziz Medical City utilizing the Bethesda III System [2001]. All abnormal smears patients' data were collected and compared to the data of randomly selected 200 normal smears' patients. Abnormal pap smear prevalence was found to be 4.3% [841/19,650 Saudi patients were found with atypical epithelial cells abnormalities]. Its prevalence in the years 2008 was 5.7%, 2009 was 4.9%, 2010 was 4.2%, and 2011 was 2.5%. Abnormal smear patients have lower parity [p=0.001], and were less likely to use intra-uterine devices [p=0.03] compared with normal smear patients. Presence of abnormal cervical appearance was associated with increased epithelial cell abnormalities [p=0.045]. The only positive history that has characterized patients with epithelial cell abnormalities was their previous history of abnormal pap smear [p=0.001]. Squamous cell abnormalities were identified in 91% of the patients [767/841], and glandular cell abnormalities were identified in 9% of the patients [74/841]. Prevalence of abnormal pap smears in central Saudi Arabia is relatively low, while advanced glandular abnormalities prevalence was observed to be high

Risk factors for postpartum hemorrhage among Saudi women

To identify health-related risk factors for the development of post partum hemorrhage [PPH] in Saudi women and to estimate the incidence of primary PPH. A case-control study was conducted between July 1, 2007 and June 30, 2008 at King Abdulaziz Medical City, Riyadh, Saudi Arabia. One hundred and one patients with PPH and 209 control patients were included. Bivariate associations between the different risk factors for the development of PPH were studied. Multivariate logistic regression analysis to identify significant risk factors for the occurrence of this obstetrics complication was carried out. High parity was associated with a 17% increased risk of PPH. Risk factors in preeclampsia was associated with >6-fold increase. History of antepartum hemorrhage [APH] increased the risk for PPH by >8-fold. Other factors were: multiple pregnancy, vaginal delivery, prolonged third stage of labor, and presence of cardiotocograph [CTG] abnormalities. Risk factors for developing PPH among Saudi women are comparable to other reported studies with a greater influence of parity, presence of APH, multiple gestation, CTG abnormalities and prolonged third stage of labor. There is a need for patient education on family planning and antenatal care, physician education on active management of the third stage, and correct estimation of blood loss

Improving inventory learning style

To look into Vermunt learning style inventory as an example of other inventories, identify the students learning style, their experience when they answered the inventory, did it help them to identify their learning style, and how it can be improved. Quantitative questionnaire, and qualitative semi structured interviews at King Abdulaziz Medical City, King Fahad National Guard Hospital, Department of Obstetrics and gynecology, from November to December 2006 were recorded. The quantitative comparison between the 17 studied students inventories revealed no significant difference between the students learning styles. In the interviews, the common themes were long questionnaire with frequency of 15/17, time consuming questionnaire 15/17, boring questionnaire 10/17, and agreement with the learning style identified 12/17. Inventory learning style questionnaires are in general time-consuming and boring to the students. They are overlapping and using different terminologies for the same meaning. A collaborative work aiming to unify all the terms and reduce the length of the questionnaire is required. We should take into consideration motivation, cultural variations and emotional factors. This will allow more reliable results, better counselling to the students, perform systematic reviews, and enrich the literature with valuable information with avoidance of wasting time and efforts

Assessment of risk factors of uterine cancer in Saudi patients with postmenopausal bleeding

To investigate whether postmenopausal bleeding [PMB] in our postmenopausal patients is a significant early symptom of uterine cancer [UC] and to assess risk factors for developing the disease in our population. A retrospective observational study conducted at King Fahad National Guard Hospital [KFNGH], Riyadh, Kingdom of Saudi Arabia. A review of documents was carried out from PMB patients who were admitted to the hospital from January 1990 through to December 2000. Factors that are usually associated with UC were studied [age, body mass index, parity, menopausal duration, past medical history, ultrasound endometrial thickness, and number of PMB episodes]. Forty-seven/one hundred and ninety-five patients [24.1%] were found to have UC. One hundred and forty-eight/one hundred and ninety-five patients [75.9%] had no pathology or a benign pathology. After adjustment for confounding variables, patient's is age >60-years and occurrence of >/= 2 episodes of PMB were the risk factors significantly related to UC development. Age 61-70-years P=0.02, odds ratio [OR] 6.8, 95% confidence interval [CI] 1.4-32.9. Age >70-years P=0.001, OR 28.4, 95% CI 3.5-156.3. Occurrence of >/= 2 episodes of PMB P=0.005, OR 4.5, 95% CI 1.6-11.8. Endometrial thickness >5mm, diabetes, hypertension and obesity were not found to be among the risk factors associated with UC development. Patient's age >60-years and occurrence of >/= 2 episodes of PMB were the risk factors significantly related to UC development in saudi patients with PMB. National risk factors assessment though case control study is required