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Article ; Online: Patient handoffs among general surgery residents in Saudi Arabia: a cross-sectional study.

Saleem, Abdulaziz M / Kadi, Mai

2022 Volume 22, Issue 1, Page(s) 626

Abstract: Background: Communication failure is a common cause of adverse events. An essential element of communication among health care providers is patient handoff. Patient handoff is defined as a practice whereby a health care provider transfers a patient's ... ...

Abstract	Background: Communication failure is a common cause of adverse events. An essential element of communication among health care providers is patient handoff. Patient handoff is defined as a practice whereby a health care provider transfers a patient's care information to another health care provider to ensure the patient's safety and continuity of care. To explore this practice, we assessed patient handoffs among general surgery residents in Saudi Arabia. Methods: A cross-sectional survey was conducted with individuals in accredited general surgery residency programs in Saudi Arabia between 2020 and 2021. Results: Participants comprised 118 general surgery residents: 66 (57.3%) were female; 67 (72.8%) did not receive any formal training on patient handoff; and 35 (38.8%) reported that they were sometimes interrupted during the patient handoff process. The most common reason for such interruptions was medical personnel paging. Furthermore, 60 (68.1%) general surgery residents stated that these interruptions led to a decreased quality of effective communication, 39 (44.3%) believed it led to decreased quality of patient care, 63 (71.5%) believed it led to the loss of some information related to patient handoff, and 16 (18.1%) believed it led to patient harm. Finally, 31 (34.4%) general surgery residents believed that the existing handoff system at their institutions neither adequately protected the patients' safety nor allowed for continuity of care, and 51 (68%) reported that their institution did not have a standardized protocol for the verbal patient handoff process. There was a higher proportion of patients with minor harm among residents who did not, rarely or sometimes received verbal or written hand off instructions compare to those who did so always or most of the time (67% vs. 49%, respectively). Conclusion: The patient handoff process among general surgery residents in Saudi Arabia is subjective and is not standardized, and if not addressed, may lead to patient harm. Standardizing this process is paramount to improve patient safety.
MeSH term(s)	Communication ; Cross-Sectional Studies ; Female ; Humans ; Internship and Residency ; Male ; Patient Handoff ; Patient Safety ; Saudi Arabia
Language	English
Publishing date	2022-08-18
Publishing country	England
Document type	Journal Article
ZDB-ID	2044473-4
ISSN	1472-6920 ; 1472-6920
ISSN (online)	1472-6920
ISSN	1472-6920
DOI	10.1186/s12909-022-03670-7
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Unusual techniques in the management of enteroatmospheric fistula. Report of a case.

Saleem, Abdulaziz / Farsi, Ali

International journal of surgery case reports

2020 Volume 75, Page(s) 292–296

Abstract: Introduction: Enteroatmospheric fistula (EAF) is one of the most challenging postoperative complications following gastrointestinal surgery. Different techniques have been reported for managing the open abdomen and controlling the effluent released from ...

Abstract	Introduction: Enteroatmospheric fistula (EAF) is one of the most challenging postoperative complications following gastrointestinal surgery. Different techniques have been reported for managing the open abdomen and controlling the effluent released from an EAF. Presentation of a case: We herein report the case of a patient who underwent bowel resection, complicated by the failure of the staple line, in the setting of an open abdomen. A male external catheter was anastomosed to the EAF opening to control the effluent and divert it away from the wound. In addition, Teflon pledgets were used to successfully patch a second, small EAF opening. Discussion: An essential element in managing EAFs is wound care and controlling the effluent from the EAF to protect the wound. Different innovative techniques have been described to manage an EAF in the setting of an open abdomen. Anastomosing the male external catheter to the EAF opening is a simple and quick technique to control the EAF effluent. Other techniques can be applied at the same time to manage the wound. Conclusion: EAF is a very challenging complication. We presented a simple and effective technique to control the EAF effluent. Multidisciplinary teams are required to manage these patients successfully.
Language	English
Publishing date	2020-09-10
Publishing country	Netherlands
Document type	Case Reports
ISSN	2210-2612
ISSN	2210-2612
DOI	10.1016/j.ijscr.2020.09.024
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Article: Phenotype and Genotype of Saudi Pediatric Patients With Neurofibromatosis Type 1: A Seven-Year Multicenter Experience From Saudi Arabia.

Alfurayh, Mohammed A / Alawad, Nawaf K / Bin Akrish, Abdulaziz M / Alharbi, Awad S / Sharahili, Ahmed / Bin Saleem, Abdulaziz S / Alrifai, Muhammad T

Cureus

2023 Volume 15, Issue 4, Page(s) e37385

Abstract: Background Neurofibromatosis type 1 (NF1) is a complex disorder. Genetics and environment might be attributed as the leading cause of NF1, which is characterized by multisystemic involvement. We aim to elaborate on Saudi children's NF1 phenotypes and ... ...

Abstract	Background Neurofibromatosis type 1 (NF1) is a complex disorder. Genetics and environment might be attributed as the leading cause of NF1, which is characterized by multisystemic involvement. We aim to elaborate on Saudi children's NF1 phenotypes and genotypes. Methods This study was conducted in the Ministry of National Guard Health Affairs (MNGHA), Saudi Arabia including three tertiary hospitals, using a retrospective cohort method. Electronic charts were reviewed to extract the variables. All Saudi pediatric patients aged less than 18 with NF1 were included. Consecutive sampling was used due to the limited number of patients. Results The study included 160 patients (81 males) with an average age of 8.08 years. Also, 33 (20.6%) patients had cutaneous neurofibroma while 31 (19.4%) patients had plexiform neurofibromas. Iris lisch nodules were seen in 33.75%. Optic pathway glioma was seen in 29 (18%) cases while non-optic pathway glioma was seen in 27 (17%) cases. Skeletal abnormalities were seen in 27 (17%) of cases. A first-degree relative with NF1 was seen in 83 (52%) of cases. Epilepsy was the presenting feature of 27 (17%) cases. Cognitive impairment was found in 15 (9.4%) patients. Genetic mutation was seen in 82/100 cases, the rest were negative. The types of mutations were as follows: nonsense 30 (36.6%); missense 20 (24.4%); splicing site mutation 12 (14.6%); frameshift 10 (12.2%); microdeletion 7 (8.5%); and whole gene deletion 3 (3.75%) patients. No phenotype-genotype correlation was seen. Conclusion In this cohort of Saudi pediatric patients with NF1, optic pathway glioma and other brain tumors were prevalent. The most common mutation is the nonsense mutation.
Language	English
Publishing date	2023-04-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.37385
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Article: Histopathological examination of cases with acute appendicitis, A retrospective study at King Abdulaziz University Hospital, Jeddah, Saudi Arabia.

Kadi, Mai / Nasr, Ali / Shabkah, Alaa A / Alnahari, Rothana / Alhawi, Afnan / Alyamani, Romaysaa / Saleem, Abdulaziz M

Annals of medicine and surgery (2012)

2022 Volume 81, Page(s) 104401

Abstract: Introduction: Appendicitis is one of the most prevalent abdominal emergencies globally. Despite the fact that acute appendicitis is a clinical diagnosis, preoperative imaging investigations are often conducted. Other disorders that might mimic acute ... ...

Abstract	Introduction: Appendicitis is one of the most prevalent abdominal emergencies globally. Despite the fact that acute appendicitis is a clinical diagnosis, preoperative imaging investigations are often conducted. Other disorders that might mimic acute appendicitis can occur in the appendix. The aim of this paper is to describe the histopathological findings of all appendectomy specimens. Methods: A retrospective study of 940 cases of appendectomy that were performed between 2010 and 2017 at King Abdulaziz University Hospital, Jeddah, Saudi Arabia were reviewed. The main outcome measured in this study is to describe the histopathological findings of all appendectomy specimens. The secondary outcomes measured in this study were the disease incidence in relation to age, and gender. Moreover, the accuracy of imaging diagnostic tools were also evaluated. Results: This study included 940 participants who underwent an appendectomy procedure. The patients' mean age was 23.4 years (±12.2), with a 3:2 male to female proportion. The incidence in males and females were 59.4% and 40.6%, respectively. Being male (p < 0.001), undergoing preoperative ultrasound (p < 0.001), having elevated white blood cells count (p < 0.001) was significantly associated with accurate diagnosis of acute appendicitis confirmed by histopathology. In this study, the negative cases of appendectomy that account for 14.4% were reported primarily as normal appendix with no inflammatory changes (7.44%) followed by other unexpected findings in the appendectomy specimen (3.93%) that included faecolith, granulomas, mucocele, endometriosis, food/fecal impaction, and schistosomiasis. Our study showed CT sensitivity as a diagnostic tool of acute appendicitis is 90.2%, and its accuracy is 89.4%, while US sensitivity is 46% and its accuracy is 52.4%. Conclusion: Histopathological evaluation after common procedures, such as appendectomy, is essential to avoid missing other pathologies in the appendix. Surgeons should be aware of the uncommon histopathology findings as some disorders call for additional management beyond appendectomy. The clinical details, radiological investigations including CT scan and histopathological diagnoses are required for better management in cases of appendicular lesions.
Language	English
Publishing date	2022-08-19
Publishing country	England
Document type	Journal Article
ZDB-ID	2745440-X
ISSN	2049-0801
ISSN	2049-0801
DOI	10.1016/j.amsu.2022.104401
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Article: Histopathological Patterns and Outcomes of Triple-Positive Versus Triple-Negative Breast Cancer: A Retrospective Study at a Tertiary Cancer Center.

Kadi, Mai S / Alhebshi, Alhasan H / Shabkah, Alaa A / Alzahrani, Walaa A / Enani, Ghada N / Samkari, Ali A / Iskanderani, Omar / Saleem, Abdulaziz M / Farsi, Ali H / Trabulsi, Nora H

Cureus

2023 Volume 15, Issue 7, Page(s) e42389

Abstract: Background One of the leading causes of cancer-related deaths in females under 45 years old is breast cancer (BC). The definition of triple-negative breast cancer (TNBC) is the lack of expression of estrogen receptors (ERs) as well as progesterone ... ...

Abstract	Background One of the leading causes of cancer-related deaths in females under 45 years old is breast cancer (BC). The definition of triple-negative breast cancer (TNBC) is the lack of expression of estrogen receptors (ERs) as well as progesterone receptors (PRs) and Erb-B2 receptor tyrosine kinase 2 (HER2) gene amplification. Triple-positive breast cancer (TPBC), on the other hand, is defined as tumors expressing a high level of ER, PR, and HER2 receptors. This study aims to assess the phenotypes of TNBC and TPBC by comparing their individual clinical behavior patterns and prognosis throughout the course of the disease in a tertiary cancer center in the Kingdom of Saudi Arabia (KSA). Methods Our study is a retrospective study using electronic medical records (EMRs) to identify all female patients diagnosed with BC using the International Classification of Diseases-10 (ICD-10) codes (between C50 and C50.9). About 1209 cases with primary BC female patients were recognized based on histopathology reports. Further subclassification into TPBC and TNBC was performed. Statistical analysis was performed using Rv3.6.2 (R Studio, version 3.5.2, Boston, MA, USA). The descriptive data were presented as means and standard deviations (SD). Survival curves were approximated using the Kaplan-Meier method. The comparison between survival curves between both groups was achieved using the log-rank test. The multivariate model was constructed based on the identified predictors using univariate analysis. Results Univariate analysis of overall survival (OS) showed that mortality was higher in TNBC compared to TPBC (HR = 2.82, P-value <0.05). However, in a multivariate analysis, molecular subtypes did not show a significant effect on OS with a P-value of 0.94. We found that age at diagnosis has been associated with a 4% increase in mortality risk with a yearly rise in age. Conclusion In this limited retrospective cohort study, we found that TNBC may not be associated with a higher risk of death than TPBC. However, other factors, including age at diagnosis, surgical intervention, and lymphovascular invasion (LVI), have been observed to increase the risk of mortality. On the other hand, patients with TNBC were found to have a worse prognosis in terms of local recurrence. This information cannot be generalized to all patients with BC given the limitations of this study. Further, larger cohorts are needed to explore biological and treatment-related outcomes in patients with TNBC and TPBC.
Language	English
Publishing date	2023-07-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.42389
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Article: Public perception of common cancer misconceptions: A nationwide cross-sectional survey and analysis of over 3500 participants in Saudi Arabia.

Marouf, Azmi / Tayeb, Rama / Alshehri, Ghady D / Fatani, Hana Z / Nassif, Mohammed O / Farsi, Ali H / Akeel, Nouf Y / Saleem, Abdulaziz M / Samkari, Ali A / Trabulsi, Nora H

Journal of family medicine and primary care

2023 Volume 12, Issue 6, Page(s) 1125–1132

Abstract: Purpose/background: Patients and healthcare providers use online health information and social media (SM) platforms to seek medical information. As the incidence of cancer rises, the popularity of SM platforms has yielded widespread dissemination of ... ...

Abstract	Purpose/background: Patients and healthcare providers use online health information and social media (SM) platforms to seek medical information. As the incidence of cancer rises, the popularity of SM platforms has yielded widespread dissemination of incorrect or misleading information about it. In this study, we aimed to assess public knowledge about incorrect cancer information and how they perceive such information in Saudi Arabia. Methods: A nationwide survey was distributed in Saudi Arabia. The survey included questions on demographics, SM platform usage, and common misleading and incorrect cancer information. Results: The sample (N = 3509, mean age 28.7 years) consisted of 70% females and 92.6% Saudi nationals. Most participants had no chronic illness. One-third were college graduates and less than one-quarter were unemployed. Conclusions: Differences in level of knowledge about cancer emerged in association with different demographic factors. Public trust in health information on SM also led to being misinformed about cancer, independent from educational level and other factors. Efforts should be made to rapidly correct this misinformation.
Language	English
Publishing date	2023-06-30
Publishing country	India
Document type	Journal Article
ZDB-ID	2735275-4
ISSN	2278-7135 ; 2249-4863
ISSN (online)	2278-7135
ISSN	2249-4863
DOI	10.4103/jfmpc.jfmpc_1753_22
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Article: Outcomes of Non-metastatic Colon Cancer: A Single-Center Experience.

Saleem, Abdulaziz M / Saber, Wafa / Alnajashi, Rawan A / Alamoudi, Ebtihal A / Shilli, Yumn H / Aljabarti, Amani M / Al-Hajeili, Marwan

Cureus

2021 Volume 13, Issue 9, Page(s) e17657

Abstract: Background Colorectal cancer (CRC) is the most common gastrointestinal cancer. In the Saudi Cancer Registry, CRC ranked as the most common cancer in men and the third most common cancer in women. Data regarding the stage of CRC at presentation and ... ...

Abstract	Background Colorectal cancer (CRC) is the most common gastrointestinal cancer. In the Saudi Cancer Registry, CRC ranked as the most common cancer in men and the third most common cancer in women. Data regarding the stage of CRC at presentation and patient demographics and outcomes in Saudi Arabia are lacking. This study aimed to investigate the prevalence, survival, and mortality rates of patients with non-metastatic CRC in a tertiary care hospital in Saudi Arabia. Methods We conducted a retrospective chart review of patients diagnosed with adenocarcinoma of the colon or rectum at King Abdulaziz University Hospital between 2013 and 2017. Patients aged ≥18 years who presented with non-metastatic CRC and underwent curative resection were included. Patients with rectal cancer or metastatic colon cancer were excluded. Data on demographic characteristics, histopathological findings, tumor-node-metastasis stage, biomarkers, and surgical interventions were collected. Recurrence-free survival was defined as the time from surgery to the date of recurrence or death. All statistical analyses were performed using Stata/IC 15.1 (StataCorp, College Station, TX, USA). Results Among 260 patients diagnosed with CRC, 82 were included based on the inclusion/exclusion criteria. Among those patients, 65.9% were men and 47.5% were Saudi citizens. The mean age at the time of diagnosis was 60.8 years. Fifty-three patients (64.6%) had left-sided colon cancer. The mean tumor diameter was 52.6 mm. Most colon tumors were T3 lesions (71.3%), and 41% of patients did not have lymph node involvement (N0). Most patients (85.1%) underwent open surgery. In the multivariate analysis, only resection margin status and N stage (hazard ratio: 17.7 and 3.7, respectively) were identified as statistically significant factors affecting the recurrence-free survival. The one-, two-, and five-year recurrence-free rates were 80.5%, 66.5%, and 57.1%, respectively, and the one-, two-, and five-year and overall survival rates were 90.3%, 82.5%, and 82.5%, respectively. Conclusions We showed significant reductions in recurrence-free and overall survival within the first two years after surgical resection. Further prospective studies are needed to explore predictors.
Language	English
Publishing date	2021-09-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.17657
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Surgical confidence when operating among residents in surgery - a cross-sectional study (SCAR study).

Awlia, Alaa M / Alotaibi, Shomokh F / Hawsa, Asya A / Sultan, Abdullah O / Trabulsi, Nora H / Akeel, Nouf Y / Malibary, Nadim H / Saleem, Abdulaziz M / Samkari, Ali A / Alburakan, Ahmed A / Kadi, Mai S / Alkhatieb, Maram T / Shabkah, Alaa A / Farsi, Ali H

BMC medical education

2023 Volume 23, Issue 1, Page(s) 414

Abstract: Background: Self-confidence, is one of the critical variables influencing surgical resident's abilities, and lack of confidence maybe a reason for not entering medical practice immediately. Measuring the level of confidence of senior surgical residents ( ...

Abstract	Background: Self-confidence, is one of the critical variables influencing surgical resident's abilities, and lack of confidence maybe a reason for not entering medical practice immediately. Measuring the level of confidence of senior surgical residents (SSRs) is a crucial step in assessing preparedness to practice. In this study, we aim to measure their confidence level and the factors that might contribute to it. Methods: Cross-sectional survey conducted at King Abdulaziz University Hospital on SSRs in Saudi Arabia (SA). We approached 142 SSRs, 127 responded. Statistical analysis was performed using RStudio v 3.6.2. Descriptive statistics were performed using counts and percentages for categorical variables and using mean ± standard deviation for continuous variables. Multivariate linear regression (t-statistics) was used to assess the factors associated with confidence in performing essential procedures, while the association between demographics and residency-related factor with the number of completed cases was tested using Chi-square. The level of significance was determined as 0.05. Results: Response rate was 89.4%. Among surveyed residents, 66% had completed < 750 cases as a primary surgeon. More than 90% of SSRs were confident in performing appendectomy, open inguinal hernia repair, laparoscopic cholecystectomy, and trauma laparotomy, while 88% were confident in being on-call in level-I trauma center. No difference was noted in confidence level in relation to the number of performed cases. Residents from the Ministry of Health accounted for 56.3% of the study population and showed a higher confidence level compared to others. 94% of SSRs plan to pursue fellowship training program. Conclusion: The study showed that the confidence of SSRs in performing common general surgery procedures was as expected. However, it's important to recognize that confidence doesn't necessarily reflect competence. Considering the majority of SSRs planned to pursue fellowship training programs, it may be time to consider changing the structure of surgical training in SA to a modular format to allow earlier and more intensive exposure.
MeSH term(s)	Humans ; Cross-Sectional Studies ; Clinical Competence ; Internship and Residency ; Mental Processes ; Surveys and Questionnaires ; General Surgery/education
Language	English
Publishing date	2023-06-06
Publishing country	England
Document type	Journal Article
ZDB-ID	2044473-4
ISSN	1472-6920 ; 1472-6920
ISSN (online)	1472-6920
ISSN	1472-6920
DOI	10.1186/s12909-023-04389-9
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Article: Body Microbiota and Its Relationship With Benign and Malignant Breast Tumors: A Systematic Review.

Samkari, Ali A / Alsulami, Meaad / Bataweel, Linah / Altaifi, Rozan / Altaifi, Ahmed / Saleem, Abdulaziz M / Farsi, Ali H / Iskanderani, Omar / Akeel, Nouf Y / Malibary, Nadim H / Kadi, Mai S / Fallatah, Emad / Fakiha, Mahmoud / Shabkah, Alaa A / Trabulsi, Nora H

Cureus

2022 Volume 14, Issue 5, Page(s) e25473

Abstract: Breast cancer is the most frequent type of cancer as well as one of the main causes of cancer-related mortality in women. Human microbial dysbiosis, which has been related to a range of malignancies, is one of the variables that may impact the chance of ... ...

Abstract	Breast cancer is the most frequent type of cancer as well as one of the main causes of cancer-related mortality in women. Human microbial dysbiosis, which has been related to a range of malignancies, is one of the variables that may impact the chance of developing breast disorders. In this review, we aimed to investigate the relationship between breast cancer and benign breast tumors with dysbiosis of the microbiome at different body sites. We performed a systematic review of MEDLINE, Scopus, Ovid, and Cochrane Library to identify original articles published until July 2020 that reported studies of breast disease and microbiota. Twenty-four original articles were included in the study, which looked at the features and changes in breast, gut, urine, lymph node, and sputum microbial diversity in patients with benign and malignant breast tumors. In breast cancer, the breast tissue microbiome demonstrated changes in terms of bacterial load and diversity; in benign breast tumors, the microbiome was more similar to a malignant tumor than to normal breast tissue. Triple-negative (TNBC) and triple-positive (TPBC) types of breast cancer have a distinct microbial pattern. Moreover, in breast cancer, gut microbiota displayed changes in the compositional abundance of some bacterial families and microbial metabolites synthesis. Our review concludes that breast carcinogenesis seems to be associated with microbial dysbiosis. This information can be further explored in larger-scale studies to guide new prophylactic, diagnostic, and therapeutic measures for breast cancer.
Language	English
Publishing date	2022-05-30
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.25473
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Article ; Online: Initial assessment of patient handoff in accredited general surgery residency programs in the United States and Canada: a cross-sectional survey.

Saleem, Abdulaziz M / Paulus, Jessica K / Vassiliou, Melina C / Parsons, Susan K

Canadian journal of surgery. Journal canadien de chirurgie

2015 Volume 58, Issue 4, Page(s) 269–277

Abstract: Background: Communication errors are considered one of the major causes of sentinel events. Our aim was to assess the process of patient handoff among junior surgical residents and to determine ways in which to improve the handoff process.: Methods: ... ...

Abstract	Background: Communication errors are considered one of the major causes of sentinel events. Our aim was to assess the process of patient handoff among junior surgical residents and to determine ways in which to improve the handoff process. Methods: We conducted nationwide surveys that included all accredited general surgery residency programs in the United States and Canada. Results: Of the 244 American and 17 Canadian accredited surgical residency programs contacted, 65 (27%) and 12 (71%), respectively, participated in the survey. Of the American and Canadian respondents, 66% and 69%, respectively, were from postgraduate year (PGY) 1, and 32% and 29%, respectively, were from PGY 2; 85 (77%) and 50 (96%), respectively, had not received any training about patient handoff before their surgical residency, and 27% and 64%, respectively, reported that the existing handoff system at their institutions did not adequately protect patient safety. Moreover, 29% of American respondents and 37% of Canadian respondents thought that the existing handoffs did not support continuity of patient care. Of the American residents, 67% and 6% reported receiving an incomplete handoff that resulted in minor and major patient harm, respectively. These results mirrored those from Canadian residents (63% minor and 7% major harm). The most frequent factor reported to improve the patient handoff process was standardization of the verbal handoff. Conclusion: Our survey results indicate that the current patient handoff system contributes to patient harm. More efforts are needed to establish standardized forms of verbal and written handoff to ensure patient safety and continuity of care.
MeSH term(s)	Adult ; Attitude of Health Personnel ; Canada ; Cross-Sectional Studies ; Female ; General Surgery/education ; Health Care Surveys/statistics & numerical data ; Humans ; Internship and Residency ; Male ; Patient Handoff/standards ; Process Assessment (Health Care)/statistics & numerical data ; United States
Language	English
Publishing date	2015-07-22
Publishing country	Canada
Document type	Journal Article
ZDB-ID	410651-9
ISSN	1488-2310 ; 0008-428X
ISSN (online)	1488-2310
ISSN	0008-428X
DOI	10.1503/cjs.016414
Database	MEDical Literature Analysis and Retrieval System OnLINE

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