The Burden Cancer-Related Deaths Attributable to High Body Mass Index in a Gulf Cooperation Council: Results from the Global Burden of Disease Study 2019.

BACKGROUND: BMI has been reported to be a major risk factor for the increased burden of several diseases. This study explores the burden of cancer linked to high body mass index (BMI) in Gulf Cooperation Council (GCC) countries and assesses the correlation with Socio-demographic Index (SDI). METHOD: Using Global burden of disease (GBD) 2019 data, the authors quantified cancer burden through mortality, DALYs, age standardized mortality rate (ASMR), and age standardized DALYs rate (ASDR) across sexes, countries, cancer types, and years. Spearman's correlation tested ASMR against SDI. The authors estimated 95% uncertainty limits (UIs) for population attribution fraction (PAFs). RESULTS: Between 1990 and 2019, all six GCC countries showed increased number of the overall cancer-related deaths (398.73% in Bahrain to 1404.25% in United Arab Emirates), and DALYs (347.38% in Kuwait, to 1479.35% in United Arab Emirates) reflecting significant increasing in deaths, and burden cancer attributed to high BMI. In 2019, across GCC countries, pancreatic, uterine, and kidney cancer accounted for 87.91% of the total attributable deaths associated with high BMI in females, whereas in male, colon and rectum cancer alone accounted for 26% of all attributable deaths associated with high BMI. CONCLUSION: The study highlights the significant impact of high BMI on cancer burden in GCC countries. Moreover, the study identifies specific cancers, such as pancreatic, uterine, and kidney cancer in females, and colon and rectum cancer in males, as major contributors to attributable deaths, urging targeted prevention strategies at reducing weight and encouraging physical activity could greatly lessen the impact of diseases in the GCC countries.

Role of preoperative computed tomography in the diagnosis of acute appendicitis and reduction of negative appendectomy rates: Retrospective cross-sectional study.

Background: Negative appendectomy rate (NAR) is defined as the incidence of pathologically normal appendices removed from patients suspected of having appendicitis. The objective of the present study is to determine the accuracy of CT and other modalities in diagnosing acute appendicitis, aiming to lower NAR in Saudi Arabia. Method: Retrospective analytical study conducted across 4 hospitals in Makkah and Jeddah. A net total of 913 patients got included in the study. The data were entered and coded in excel sheet, then transformed to STATA R. software for analysis. Results: A total of 911 patients who underwent appendectomy were included in this study; positive appendectomies were proven in (96.49%) of cases resulting in overall (3.51%) of cases of negative appendectomy when analyzing data based on age groups; adult patients who proceeded to the surgery based on clinical examination only had a NAR of (13.16% vs 2.66% who had one or more imagining studies P = 0.000). Conclusion: Despite the fact that the diagnosis of acute appendicitis is often challenging, the patients who proceeded to the surgery based on clinical examination only had a NAR higher than those who underwent one or more imaging studies. The NAR was higher in women than men adult patients while no relation was observed in pediatric patients. Based on the present study's findings, efficient pre-operative radiological utilization is recommended in cases presented with suspicious acute appendicitis. Moreover, investing in radiological equipment and time for proper assessment can avoid the unnecessary appendectomy.

Role models as a factor influencing career choice among female surgical residents in Saudi Arabia: a cross-sectional study.

BACKGROUND AND PURPOSE: Role models in the medical field are professional and experienced persons whose actions unconsciously inspire juniors to strive to be like them. To our knowledge, no studies have examined whether having a female surgical role model has influenced women to pursue a surgical career in Saudi Arabia. Hence, we sought to evaluate whether identifying role models in surgery influences career choice and defined the ideal qualities of a surgical role model as perceived by newly qualified doctors. METHODS: We employed a cross-sectional, survey- based study design, conducted between June 2020 and January 2021, in which female surgical residents completed a questionnaire about their perceptions and influence of role models in general surgery specialty at the time they pursue a career in surgery. RESULTS: A total of 51 respondents completed the questionnaire. The majority of them (78.4%) had a role model and (19.6%) indicated that their role model was a female. Of those who had a role model, (67.5%) agreed that they experienced a positive influence on their surgical career choice. Clinical and operation skills were reported as the most remarkable factor to be considered in their role models. Working directly with a male surgical consultant and female surgical residents imprinted a positive influence but this did not reach a statistical significance. CONCLUSION: The findings of this article contribute empirically to the strong effects of the same-sex role models and highlight the curial role of surgical residents in influencing female's career choices in general surgery as an achievable and attainable domain. Which encourage the creation of national mentorship programs and exploring more in barriers for pursuing a surgical career.

Gitelman syndrome: A first published clinical association with chronic pancreatitis, a case report and review of literature.

INTRODUCTION AND IMPORTANCE: Gitelman syndrome (GS) is an autosomal recessive, salt-losing tubulopathy, also referred to as familial hypokalemia-hypomagnesemia, caused by mutation of genes encoding the sodium chloride cotransporter (NCCT) and magnesium transporters in the thiazide sensitive segments of the distal convoluted tubule (DCT) of the nephron. Patients may present with a spectrum of clinical presentations and associations. CASE PRESENTATION: Here, we report a case of a 39-year-old female with Gitelman syndrome and chronic pancreatitis in the absence of well-known causes of CP. Her clinical and radiographic profile constituted an indication for surgical intervention, namely pancreatic head and body coring and pancreaticojejunostomy (Frey's procedure) (FP). On follow up 3 month later, the patient is pain-free and is satisfied. To the best of our knowledge and based on literature review, this is the first reported case of GS with CP. CONCLUSION: The purpose of this paper is to describe a case of CP in association with established GS as a first published clinical association, raising a possibility of another possible clinical manifestation of GS. Further observational studies are encouraged to support this association.

Delayed presentation of an isolated sigmoid Colon injury following blunt abdominal trauma: A case report with review of literature.

INTRODUCTION AND IMPORTANCE: Isolated Colon injury due to blunt abdominal trauma is very rare. Due to lack of a definitive diagnostic method; it's very challenging to detect such injury and this will lead to delay in treatment and subsequently resulting in high morbidity and mortality. The current literature is relatively sparse concerning the management of blunt colon injuries. CASE PRESENTATION: Here, we report a case of a 17-year-old male patient with isolated sigmoid injury presented 5 days after MVC. He underwent sigmoid resection and end colostomy followed by reversal 6 weeks later. Currently, the patient is disease-free with a completely healed wound. CONCLUSION: The purpose behind this paper is to raise clinical suspicion regarding delayed presentation of blunt abdominal trauma and it effect on operative decision, so that timely diagnosis and proper management could be carried out. And to discuss the applicability of the defined management algorithm for penetrating colon injury on delay blunts colonic injury.

Residents' perspectives: Does the Saudi general surgery residency training program apply CanMEDS competencies and prepare future leaders?

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.

CONTEXTE: Cette étude se penche sur les compétences en leadership et l'acquisition de compétences CanMEDS (Canadian Medical Education Directives for Specialists - directives canadiennes en formation médicale pour les spécialistes) au sein du GSRTP (programme de formation en résidence en chirurgie générale). La SCFHS (commission saoudienne pour les spécialistes de la santé) intègre le cadre des compétences CanMEDS dans son programme pour préparer les résidents aux besoins en matière de soins de santé. MÉTHODES: Il s'agit d'une étude descriptive et analytique. Un questionnaire a été utilisé pour collecter des données auprès de 117 résidents en chirurgie générale dans sept instituts médicaux à Djeddah, Arabie saoudite. RÉSULTATS: Les résidents en chirurgie générale ont rapporté un niveau perçu acceptable de compétences en leadership clinique (moyenne ± écart type) La compétence la plus dominante était le travail avec les autres (1,98 ± 1,03), suivi par la démonstration de qualités personnelles (2,07 ± 0,88), la capacité de gérer les services (2,1 ± 1,37), l'amélioration des services (2,22 ± 1,84) et, finalement, l'établissement des orientations (2,39 ± 0,95). En ce qui a trait aux compétences CanMEDS, les répondants ont montré une perception généralement positive avec un niveau « d'accord ¼ (moyenne = 1,83). En ce qui a trait aux rôles associés aux compétences CanMEDS, celui de collaborateur s'est classé au premier rang, suivi par celui de professionnel et ensuite de communicateur. Le rôle de chef de file s'est classée quatrième en matière de compétence, suivie de défenseur de la santé, d'expert médical et, finalement, d'érudit. CONCLUSION: Les résidents du GSRTP ont montré une satisfaction en matière de compétences de leadership clinique autoévaluées et d'acquisition des compétences CanMEDS lors de leur formation, laquelle les préparera à jouer un rôle de premier plan dans l'avenir.

Necrotizing Fasciitis of the Breast: Case Report with Literature Review.

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.

Awareness of epidural analgesia among pregnant women in Jeddah, Saudi Arabia.

BACKGROUND AND OBJECTIVE: Labor 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. METHODS: This 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. RESULTS: According 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). CONCLUSION: This 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.

Rhabdomyosarcoma of the genital tract in an 18-month-old girl.

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.