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Objectives: The primary goal of this study was to systematically identify all relevant published articles on the use of primary endoscopic balloon dilation for the management of pediatric patients with subglottic stenosis, critically assess the technique's success, and determine which patients are the best candidates for the procedure., Methodology: This was a systematic review and meta-analysis that aimed to investigate the use and success rate of EBD for treating pediatric SGS. An electronic systematic literature search of three major databases, PubMed, EBSCO, and Web of Science&MEDLINE through Clarivate, was conducted to include the eligible articles., Results: A total of 14 unique studies were included in the final analysis, with 473 cases of pediatric SGS. The pooled success rate of EBD in treatment of pediatric SGS was 76% (k = 14 studies, 95% confidence interval [CI] = 0.65-0.86, P < 0.001, Q test for heterogeneity = 0.03, P < .001, I 2  = 91%)., Conclusions: We reported a high success rate of EBD in treating pediatric SGS. The reported complications were uncommon, although they can be serious and life threatening. The intensity of SGS may be related to the likelihood of therapy failure., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Introduction  Unplanned hospital returns are frequent and may be preventable. Objective  To comprehend the reasons for unplanned hospital readmission and return to the Outpatient Department (OPD) and Emergency Department (ED) within 60 days after discharge following head and neck surgery (HNS) at a tertiary care center in Saudi Arabia. Methods  In the present retrospective study, the medical records of all patients who underwent HNS for benign and malignant conditions between January 2015 and June 2022 were reviewed in terms of demographic data, comorbidities, and reasons for hospital return. Results  Out of 1,030 cases, 119 (11.55%) returned to the hospital within 60 days after discharge, 19 of which (1.84%) were readmitted. In total, 90 (8.74%) patients returned to the OPD, and 29 (2.82%), to the ED. The common reasons for readmission included infections (26.32%) and neurological symptoms (21.05%). For OPD visits, the common causes were hematoma (20%) and neurological symptoms (14.44%). For ED returns, the frequent causes were neurological symptoms (20.69%) and equipment issues (17.24%). Compared with nonreadmitted patients, readmitted patients had a higher preoperative baseline health burden when examined using the American Society of Anesthesiologists (ASA) score ( p  = 0.004) and the Cumulative Illness Rating Scale (CIRS; p  = 0.002). Conclusion  The 60-day rates of unplanned hospital return to the OPD and ED were of 8.74% and 2.82% respectively, and 1.84% of the patients were readmitted. Hematoma, infections, and neurological symptoms were common causes. Addressing the common reasons may be beneficial to decrease postoperative hospital visits., Competing Interests: Conflict of Interests The authors have no conflict of interests to declare., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit ( https://creativecommons.org/licenses/by/4.0/ ).)

Introduction: Plastic surgery is a medical specialty involving the restoration, reconstruction, or alteration of the body. Knowledge about facial plastic surgery among doctors is limited according to some literatures and enriched according to others, depending on the country and study population., Aim: Aim of the study was to evaluate level of knowledge of health care professionals regarding facial plastic surgery., Material and Methods: A cross-sectional study included total of 261 health care professionals (consultants, specialists and residents in training) at King Abdul-Aziz University Hospital (KAUH) from all subspecialties during July 2018. The data collected using pre-designed questionnaire and analyzed using professional statistics software., Results: Among 261 participants, sex distribution shows a male-female ratio of 2.78:1. The majority (62.8%) of participants were residents. Mean age (± SD) of participants was 32.28 ± 8.43. Pediatrics, internal medicine, and general surgery were the most common specialties. Among participants, 75.5% agreed that taking training in plastic surgery program is a requirement to be a facial plastic surgeon whether it should be accompanied with at least one other surgery training (23%) or more than one other training (22.2%). The majority (97.7%) have never undergone a facial plastic surgery operation and 78.2% were not willing to undergo one., Conclusion: The study concludes that the knowledge and perception among healthcare professionals in KAUH regarding facial plastic surgeries is on relatively good basis but needs more updates and trainings., Competing Interests: Authors declared no conflict of interest., (© 2019 Abdullah A. Alamri, Reham AlJehani, Majed N. Alnefaie, Sabah Moshref, Abdulkareem R. Fida.)

Introduction: Plastic surgery is a medical specialty involving the restoration, reconstruction, or alteration of the body. Knowledge about facial plastic surgery among doctors is limited according to some literatures and enriched according to others, depending on the country and study population., Aim: Aim of the study was to evaluate level of knowledge of health care professionals regarding facial plastic surgery., Methods: A cross-sectional study included total of 261 health care professionals (consultants, specialists and residents in training) at King Abdul-Aziz University Hospital (KAUH) from all subspecialties during July 2018. The data collected using pre-designed questionnaire and analyzed using professional statistics software., Results: Among 261 participants, sex distribution shows a male-female ratio of 2.78:1. The majority (62.8%) of participants were residents. Mean age (± SD) of participants was 32.28 ± 8.43. Pediatrics, internal medicine, and general surgery were the most common specialties. Among participants, 75.5% agreed that taking training in plastic surgery program is a requirement to be a facial plastic surgeon whether it should be accompanied with at least one other surgery training (23%) or more than one other training (22.2%). The majority (97.7%) have never undergone a facial plastic surgery operation and 78.2% were not willing to undergo one., Conclusion: The study concludes that the knowledge and perception among healthcare professionals in KAUH regarding facial plastic surgeries is on relatively good basis but needs more updates and trainings., Competing Interests: There are no conflicts of interest.

Introduction: Musculoskeletal (MSK) manifestations represent a common work-related physical complication that affect surgeons and impacts their life and the healthcare service negatively., Aim: The aim of this study was to determine the prevalence of work related MSK manifestations among surgeons in a tertiary care hospital and to identify the possible associated risk factors., Methods: A Web-based self-administered cross-sectional survey was conducted. This study targeted all surgeons regardless of their nationalities, ages, genders, and marital statuses. The questionnaire assessed the participants' demographic data as well as musculoskeletal manifestations., Results: Most respondents (80%) suffered from MSK manifestations that were related to performing surgeries. Back and neck areas represented the most affected body parts (71.1% and 59.8%, respectively). A significantly higher percentage of those with musculoskeletal manifestations practiced for 5-10 years (28.9%) (p = 0.006)., Conclusion: MSK pain is common among Saudi surgeons in different specialties. More attention should be directed to improving the physical environments in which the surgeons are operating. Moreover, surgeons should be educated about the recommended ergonomic positions that can prevent or decrease their work related MSK manifestations.

Introduction: Blood transfusion practices affect both patient's outcomes and utilization of institutional resources. Evidence shows that liberal blood transfusion has a detrimental effect on patient's outcome. A restrictive approach of blood transfusion is recommended by current clinical guidelines., Aim: The aim of this study was to evaluate the attitudes, knowledge, and practices of general surgery (GS) staff and residents regarding peri-operative blood transfusion and anemia management., Material and Methods: A self-administered, web-based questionnaire was developed, and its link was sent to the emails of all general surgeons at King Abdul-Aziz University Hospital (KAUH), Jeddah city, Saudi Arabia. The questionnaire included four parts: 1) background of surgeons; 2) preoperative assessment and management of anemia; 3) post-operative blood transfusion and alternatives; and 4) enablers and barriers., Results: 56 surgeons responded to the questionnaire. We found variations in blood transfusion practices, notably the hemoglobin threshold. For stable non-cardiac cases, 7 g/dL was considered the threshold by 50% of respondents. For stable patients with past cardiac disease, a higher threshold was chosen by most (9 g/dL by 43% and 10 gm/dL by 21%). Most respondents believed that transfusion had no effect on the risk of survival (73%) and on the risk of cancer recurrence (55%) after oncologic surgical resection. Recognized facilitators were the availability of scientific evidence (84%), medicolegal concerns (57%), preference (52%), and institutional protocols (50%)., Conclusion: Although current clinical guidelines recommend a restrictive transfusion practice, most respondents tended to over-order blood for elective procedures and were not aware of the potential complications of liberal blood transfusion. To implement the restrictive transfusion policies, health institutions should improve the awareness of surgeons and incorporate a strong supporting evidence in formulating local institutional guidelines.

Objectives: To determine the attitudes of obstetric and gynecological patients towards medical students' participation in clinical care., Methods: Patients in an obstetric and gynecological practice in Kingdom of Saudi Arabia, completed a structured self-administered online questionnaire to assess demographic, reproductive and lifestyle variables that affected their attitude towards the acceptance of medical students' participation in outpatient clinical care., Results: Out of the 595 women surveyed, 64.7% received perinatal care, while 35.3% received gynecologic care. Women mostly held positive attitudes towards medical students' participation. Women expressed more comfort with medical students' involvement during limited clinical care roles such as obtaining patient's history and physical examinations without a pelvic examination. Women reported higher comfort levels in the presence of female medical students, especially during pelvic examinations. The presence of male medical students caused a significant reduction in patient's comfort., Conclusion: Our results suggest that women seeking obstetrics and gynecology medical services are accepting students' involvement during the healthcare encounter. Most patients are more comfortable if direct contact with students is minimized and students' participation in medical care is restricted to more limited roles. In addition, the student's gender is a significant determinant of patient's acceptance and comfort during the clinical encounter.

Objectives: We sought to estimate the prevalence of hypertensive disorders of pregnancy (HDP) in Saudi Arabia as well as the risk factors of HDP, and maternal and fetal outcomes., Methods: We retrospectively evaluated the medical records of 9493 women who delivered at King Abdulaziz University Hospital, a tertiary care center, between January 2015 and June 2017. All cases of HDP were included., Results: We identified 224 pregnant women with HDP in our patient cohort, giving a prevalence of 2.4%. Their mean age was 31.3±6.7 years, with an average gravidity of 4.0 and average parity of 3.0. The most prevalent subtype of HDP was preeclampsia (54.9%) while 29.5% of the women had gestational hypertension, and 8.0% had eclampsia. The prevalence of subtypes of HDP differed significantly with gravidity, and mean age differed significantly with HDP subtype. Personal and family histories of preeclampsia and the presence of diabetes were more prevalent in women with preeclampsia and gestational hypertension; however, only the difference in diabetes prevalence was significant. The overall prevalence of maternal complications was 9.4% and the prevalence of maternal mortality was 1.3%. Multigravid women and women with chronic hypertension were at increased risk of prematurity compared to other pregnant women, but not significantly., Conclusions: The prevalence of HDP was relatively low in our cohort. However, to prevent harmful impacts on both the mother and fetus, screening for this disorder is recommended early in pregnancy.