Criteria of acceptance in the Saudi program of anesthesia and intensive care.

BACKGROUND: The scientific congress of Anesthesia and Intensive Care of the Saudi Commission for Health Specialties aims to review and improve the guidelines for the selection process of trainees, a selection process that is based on equal opportunity and upholds the principles of consistency, objectiveness, transparency, and procedural fairness. The study represents a step toward the goal of fostering quality patient care, by adopting a selection process that would result in graduating good, committed, and competent specialists. MATERIALS AND METHODS: Reports of admission examinations in Jeddah, Riyadh, and the Eastern region have been collected, and they contain detailed lists of names, scores, and percentages of the criteria of admissions, that is, MBBS 25%, General Examination 50%, Interview 25%, and overall score of 100%. RESULTS: Mean MBBS scores, average general examination scores, average interview scores, and average overall scores were not statistically different between candidates from different regions. The leading predictor was the 'Interview Score'. 49.5% of variation in the dependent variable (overall score) could be significantly explained (F = 69.4, P < 0.05) by the independent variable 'Interview Score'. The second predictor was the 'MBBS score'. CONCLUSION: The three components MBBS, General Examination, and Interview, were significant predictors of the overall score. The leading predictor was the 'Interview Score'. The author recommended that the selection process should be under continuous review. The general interview guide approach is recommended to ensure that the same general areas of information are collected from each interviewer. Questions of a personal or discriminatory nature should be avoided.

Morphological profile of testicular biopsies associated with infertility.

OBJECTIVE: Based on testicular biopsies examined at King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia, the goal of this retrospective study is identification and systemization of the histopathological patterns of testicular biopsies received especially for investigating male infertility and further more to compare the findings of our study with similar studies in the literature. METHODS: Our study group consisted of 164 testicular biopsies, which were examined in the Department of Histopathology at King Abdulaziz University Hospital in Jeddah, over a period of 10 years. The data was retrieved and analyzed and the available histopathological results were grouped into 8 different morphological categories. RESULTS: The findings of the biopsies associated with infertility were complied as follows: 45 (27%) showed normal spermatogenesis of which 15% showed active spermatogenesis associated with duct obstruction, 41 (25%) with hypospermatogenesis, 39 (24%) showed end stage tubular sclerosis with interstitial fibrosis, 27 (16.5%) with germ cell aplasia (with or without focal spermatogenesis), 11 (7%) biopsies showed maturation arrest and only on biopsy were associated with karyotpic abnormalities. CONCLUSION: A higher percentage of hypospermatogenesis and end stage tubular sclerosis with interstitial fibrosis was noticed in this study when compared with the other studies reported from Saudi Arabia. A high percentage (27%) of the biopsies show normal spermatogenesis with or without duct obstruction.

Pattern of breast diseases in a teaching hospital in Jeddah, Saudi Arabia.

OBJECTIVE: The aim of this case series study is to evaluate the outline and pattern of male and female breast diseases in Saudi Arabia. Also to compare 8 studies of literature discussing the profile of malignant and benign female breast diseases in the Kingdom. We hope that this study will assist us to appreciate the prototype breast diseases in our region. METHODS: Our study consisted of 1084 consecutive male and female breast lesions. Data on these specimens, received in the time frame of 15 years between January 1984 and March 2000, was retrieved from the records of the laboratory. The outline of breast lesions were tabulated and classified into inflammatory, benign and malignant lesions. RESULTS: In female breasts, benign lesions comprised 57% of all lesions (mean age 28.5), most commonly reported being fibroadenoma 47%, fibrocystic disease 22% and fibroadenosis 14%. Malignant lesions comprised 32.5% of all lesions (mean age 48.49), most commonly reported being ductal carcinoma 88% and lobular carcinoma 4.5%. Inflammatory lesions comprised 11% of all lesions (mean age 35.0), most commonly reported lesion being chronic mastitis 31% and ductectasia 19%. Male benign lesions comprised 55 cases (87%). Eight cases (13%) of malignant lesions, 6 ductal carcinomas and 2 metastatic adenocarcinomas, were also identified. CONCLUSION: The rates for female breast lesions varied in different studies but benign fibroadenoma constituted the most common breast lesion and secondly ductal carcinoma. The mean age for malignant lesion in 7 different studies came to be 44.05. In the male breast, carcinomas constituted 3% of all breast carcinomas. Gynecomastia being the most common male breast lesion constituting 54%.

Analysis of false positive and false negative cytological diagnosis of breast lesions.

OBJECTIVE: To study the reasons for interpretive errors in false negative and false positive diagnosis of breast carcinoma on fine needle aspiration cytology material. METHODS: We reviewed only those cases in which cytohistological discrepancies were found, where the cytologic material was abnormal and to some extent misinterpreted or both. RESULTS: There was only one false negative case (false negative fraction 0.32%) proved histologically as ductal carcinoma and four false positive cases (false positive fraction 1.2%); 2 fibroadenoma; 1 fibrocystic disease; and 1 stromal fibrosis. Smears of the two false positive fibroadenoma cases showed very high cellularity, overcrowded clusters and frequent stripped nuclei. The fibrocystic case showed tight clusters of apocrine cells and sheets of loosely aggregated macrophages that were over interpreted. Smears of the false negative ductal carcinoma was hypocellular overall, and the cells showed minimal nuclear pleomorphism. CONCLUSION: Overcrowded clusters and hypercellular smears should be carefully assessed for uniformity of cells and detailed nuclear and cytomorphological features. If the full-blown malignant cytomorphological changes are not visible, a diagnosis of suspicious or inconclusive should be made and frozen section recommended before surgery. Hypocellularity and relatively nuclear monomorphism are the reasons for failure to diagnose malignant breast lesions. Careful attention should be paid to extreme nuclear monomorphism and absence of naked bipolar cells. A cytologically atypical or suspicious diagnosis together with positive radiological and clinical findings should suggest a diagnosis of malignancy.