Bronchoscopy, indications, safety and complications.

OBJECTIVE: To review the safety, indications, complications of flexible fiberoptic bronchoscopies performed at university teaching hospital, and to correlate the bronchoscopic findings with radiology, histology, and history of smoking. METHODS: A total of 124 consecutive flexible fiberoptic bronchoscopies were reviewed in the last 3 years. A special form that contains personal data, indications, premedications, route of insertion, bronchoscopic findings, and complications in subjects-undergone bronchoscopy was completed. RESULTS: A suspicion of pulmonary tuberculosis (31%), lung mass (19%) and hemoptysis (18%) were the most common indications. Hypoxemia (14%) during procedure and pneumothorax post procedure were the most common complications. Mortality rate was 0%. For 57% of subjects who had histology, lung cancer (44%), and tuberculosis (15.5%) were commonly found. Lung cancer (72%) and tuberculosis granuloma (18%) were mainly responsible for narrow segments during bronchoscopy. A radiological tumor like mass was found histopathologically to be as lung cancer in 86% and as tuberculous granuloma in 5%. About 84% of lung cancer patients were either smokers (57%) or ex-smokers (27%) as compared to only 35% in smokers and 13% in ex-smokers in patients without lung cancer, P-value<0.01. CONCLUSION: Flexible fiberoptic bronchoscopy can be performed safely whenever indicated. Complications occurred were minor and self limiting. Appropriate preparation, and close supervision and adherence to the protocol were essential for a successful and safe procedure.

Pattern of bacterial resistance in the western region of Saudi Arabia.

Common organisms which were isolated from patients attending the King Abdulaziz University Hospital in Jeddah were tested against antibiotics commonly used for their eradication. About 500 isolates of each bacterium were tested, showing a different resistance pattern from that obtained in Western countries. For example, methicillin resistance by staphylococci was different from that found in the United Kingdom, 100% of pneumococci were sensitive to penicillin and pseudomonas resistance to carbenicillin was only about 3%. S. typhi resistance of Chloramphenical was nil. This paper emphasizes the most appropriate antibiotic for each organism and the different pattern of bacterial resistance in Saudi Arabia as compared to that in Western countries.

Problems of undergraduate medical education in Saudi Arabia.

Throughout the world there are problems associated with undergraduate medical education, and likewise in Saudi Arabia. In this paper, some of these problems are discussed and solutions suggested, in the context of a survey conducted at the Faculty of Medicine of King Abdulaziz University with fourth-year medical students dealing with the language of medical instruction.

Pattern of liver disease in the western region of Saudi Arabia.

In a series of 124 patients admitted to hospital with liver disease, 23 (18.6%) had malignant liver disease, either primary or secondary; 12 (9.7%) had cirrhosis of the liver, while another 25 (20.2%) had inflammatory liver disease, including such parasitic infections as hydatid disease and schistosomiasis. The remaining biopsies showed non-specific changes or normal livers.