survey of the practice of regional anesthesia in Saudi Arabia

This survey aimed to assess both the extent of practice and need for training in regional anesthesia among anesthesiologists in Saudi Arabia in 2012. We distributed an electronic survey among 382 anesthesiologists attending the bi-annual meetings of the Saudi Anesthetic Association, enquiring about their practice in regional anesthesia. Questions concerned the practice of regional anesthesia, use of ultrasound guidance, and the need for training workshops. The response rate of anesthetists was 55.2% with most of them were males and had mean age of 25-50 years. Most anesthesiologists [88.2%] were practicing regional anesthesia frequently in the operating rooms [75.3%] rather than designated block room. From the respondents, only 14.2% did fellowship in regional anesthesia, 21.8% and 18.5% were using ultrasound and nerve stimulation guidance, respectively, 11.4% received formal training, and 86.3% were willing to attend training workshops on regional anesthesia. There was a significant negative correlation between the ultrasound users and their institutional positions [r=-0.191] [P=0.026]. We believe that more could be done to improve the practice of regional anesthesia in the Kingdom of Saudi Arabia, including the implementation of formal training and conduction of more frequent specialized courses/workshops in the field of regional anesthesia with special reference to ultrasound regional anesthesia blockade techniques

How to set up a standard regional anesthesia service?

The practice of regional anesthesia is getting more popular after the introduction of ultrasound technology in anesthesia practice. The biggest obstacle in conducting regional anesthesia is the delay in operation room time. This brief report focuses on the set up of the so called "block room"

rear case of congenital anterior diaphragmatic hernia

We report a case of a newborn with the rare anterior diaphragmatic hernia with herniation of the liver into the pericardial sac that posed a diagnostic dilemma in our Neonatal Intensive Care Unit [NICU]. An anterior diaphragmatic hernia should be suspected in any newborn with an anterior mediastinal mass or a pericardial effusion. A MRI of the chest helped to confirm the diagnosis. The relevant literature is reviewed

Tuberculous lymphadenopathy: an approach to diagnosis and management

The aim of the study is to determine the incidence of peripheral tuberculeus lymphadenopathy in western region of Saudi Arabia, its clinical presentation, the diagnosis and the assessment of the value of short-term chemotherapy.A prospective study of 64 consecutive patients with proven tuberclous lymphadenpathy were included in this study, using FNA and/ or lymph node excisional biopsy. Of the sixty-four patients included in the study, seventeen [26.6%] were males and 47 [73.4%] females. Their ages ranged from 18 to 96 years with a mean age of 40 years. The number of patients who presented with constitutional symptoms was 33 [51.6%].There was a preponderance of females; the female to male ratio was 2.7%, consistent with other studies. Matting and fixation of the nodes to the surrounding structures was present in 24 [37.5%] patients, while the nodes were discrete in the rest. Among which discharging sinuses and abscesses were noted in 10.9% and 7.8% of the cases respectively. Conclusions: The diagnostic yield of FNA can be augmented by performing two FNA attempts. One to be sent for cytopathological examination and the other for AFB smear examination and Mycobacterial culture. A short course of combined chemotherapy consisting of rifampicin [600 mg orally once daily], INH [10mg/kg daily] and pyrazinamide [15 mg/ kg] for 6 months and ethambutol [15mg/kg] for 2 months was an effective and satisfactory therapy in our patients, as proven by the lack of recurrence or relapse after 5 years of follows up

Accidental injuries during muslim pilgrimige

The diseases that occur during Hajj are a unique medical problem. The aim of this study is to highlight the incidence, the type and the early surgical management of trauma during the Hajj period. A prospective study was carried out during a 15 day-period conducted in two parts in the emergency room, and a follow-up of the admitted patients in the surgical department. The number of trauma cases who attended the emergency department was 713 patients, 248 patients were admitted in different surgical departments, together with the intensive-care unit. Sixty-five% of the patients were discharged from emergency room as they had minor trauma. Sixty% were involved in road traffic accidents, 15% had injuries in Holy Haram. Limb fracture accounts for 53% of total trauma admissions. Two patients died in the first 48 hours. Trauma during Hajj is a real surgical problem which deserves more attention. Orthopedic and Neurosurgical cases are the most common surgical cases during the Hajj period

Quality improvement plan for surgical departments

The rising awareness of patients about medical care and the great competition among doctors and health organizations, besides limited resources, put a lot of pressure on hospitals to implement quality improvement programs. Surgeons are the most affected people by these factors and they have not only to be aware or participate in those programs but to be leaders of quality improvement programs. In this paper we tried to collect the guidelines for a quality improvement program for surgical departments