Prevalence of Breast Tumors and Methods of Prevention: A Cross-sectional Study

Background: Breast cancer is one of the most prevalent forms of cancer in women and one of the most severe and significant public health concerns in developing nations. This study aimed to determine the prevalence of breast tumors and women’s preventive behavior. Methods: A descriptive, correlational cross-sectional design was employed for this study. The study was conducted at (jeddah). Participants were selected during the period from September to November 2022. Population of this study were adult women (Aged >18 years) at KSA. Study instruments consisted of the following domains sociodemographic data, anthropometric measurements, information related to menstrual cycle and pregnancy, obstetric history, family history, practices of breast self-examination, procedures of early detection and knowledge, attitude and practice assessment for methods of prevention. Results: The study included 420 women of different ages. Breast cancer was found among 82 women (19.5%). The mean age among all study participants was 33.96 + 14.79 years with median age of 28 years. More than half of study participants had normal BMI (n= 220, 52.4%) while third participants were overweight (n= 136, 32.4%). Among participants, 18.1% had a history of post-partum complications, 38.3% had undergone previous surgery, 1.4% had experienced vascular moles, 18.6% had a history of fibroid uterus, 6% had cervical polyps, and 5% had endometriosis. Table 3 presents obstetric history among study participants. More than half of study participants underwent previous hysteroscopy (n= 235, 56%). On the other hand, 81 women had a family history of breast cancer (19.3%). Most of women in this study perform self-examination of the breast (n= 300, 71.4%) and 102 women underwent fine needle aspiration procedure (FNA) (24.3%). The FNA result was positive among 81 women. Furthermore, 124 women underwent mammography (29.5%) and the result was positive among 67 participants. Breast cancer is found among 82 women (19.5%). Women in this study agreed that they should have clinical breast examination at any time (n= 191, 45.5%) while other women believed they should have this examination in certain circumstances such as mastodynia (n= 61, 14.5%), history of benign breast tumors (n= 38, 9%), obesity (n= 37, 8.8%) and family history of breast cancer (n= 32, 7.6%). Conclusion: Breast cancer prevalence was 19.5%. Urban residency was predominant, with varying educational levels. Marital status, income, family size, and work differed among participants. Chronic conditions and diverse anthropometric measurements were observed. Obstetric history showed early marriage and delivery ages, limited abortions, and varied complications. Family history indicated links to chronic diseases and cancers. Participants exhibited awareness about breast cancer risk factors and methods for early detection

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Management of a Difficult-to-Treat Diabetic Foot Wound Complicated by Osteomyelitis: A Case Study

Introduction. Diabetic ulcers are a major health issue worldwide, causing significant economic burdens and affecting both the patient and the society as a whole. Predisposing factors in diabetic patients, known as the pathogenic triad, comprise trauma, ischemia, and neuropathy. Regardless of the cause, correct diagnosis and prompt treatment are essential in the management of leg ulcers. Case History. We report a case of a 51-year-old male patient, with a known history of type 2 diabetes mellitus who presented to our hospital with a history of two ulcers, one that he was mainly complaining of, which was actively infected and located at the posterior part of the distal left leg, and the second, dry ulcer caused by unrecognized trauma, located on the heel of the same limb. Magnetic resonance imaging showed osteomyelitis and degenerative changes in the calcaneonavicular and tarsal joints. The patient underwent multiple sessions of excisional debridement. He was started on negative pressure wound therapy with some improvements. However, after skin graft failure, Nanoflex powder was used, leading to complete wound closure within one month of treatment. Conclusion. A multidisciplinary holistic approach must be used when treating diabetic foot ulcers. Different modalities and sessions of debridement should be performed after optimizing the general condition of the patient

Management of a Difficult-to-Treat Diabetic Foot Wound Complicated by Osteomyelitis: A Case Study

Introduction. Diabetic ulcers are a major health issue worldwide, causing significant economic burdens and affecting both the patient and the society as a whole. Predisposing factors in diabetic patients, known as the pathogenic triad, comprise trauma, ischemia, and neuropathy. Regardless of the cause, correct diagnosis and prompt treatment are essential in the management of leg ulcers. Case History. We report a case of a 51-year-old male patient, with a known history of type 2 diabetes mellitus who presented to our hospital with a history of two ulcers, one that he was mainly complaining of, which was actively infected and located at the posterior part of the distal left leg, and the second, dry ulcer caused by unrecognized trauma, located on the heel of the same limb. Magnetic resonance imaging showed osteomyelitis and degenerative changes in the calcaneonavicular and tarsal joints. The patient underwent multiple sessions of excisional debridement. He was started on negative pressure wound therapy with some improvements. However, after skin graft failure, Nanoflex powder was used, leading to complete wound closure within one month of treatment. Conclusion. A multidisciplinary holistic approach must be used when treating diabetic foot ulcers. Different modalities and sessions of debridement should be performed after optimizing the general condition of the patient.</jats:p

Common pathogens associated with infected diabetic foot ulcers: A retrospective cohort study in a specialized medical center in Jeddah, Saudi Arabia

Background: Foot infections, a frequent complication of diabetes mellitus, are associated with heavy resource utilization, including antibiotic therapy and surgeries. However, the most common type of isolated pathogen in diabetic foot infections remains unknown. We aimed to identify the most common types of isolated pathogens in diabetic foot infections. Methods: This retrospective cohort study was conducted in a specialized medical center in Jeddah, Saudi Arabia. A total of 96 patients diagnosed with diabetes and presented with a foot ulcer showing clinical signs of infection were included. Results: The mean age was 63.03 ± 10.88 years, and 67.7% were males. The mean duration of diabetes diagnosis was 21.86 ± 9.66 years, and the majority had foot ulcers for over six weeks. Bacteria were present in 65 patients (67.7%), Gram-negative organisms were observed in 37 patients (38.5%), and Gram-positive organisms were present in 28 patients (29.2%). In the 65 patients with bacterial culture, Staphylococcus aureus was the most common isolated organism and was observed in 18 patients (27.7%), followed by Escherichia coli in 11 (16.9%) and Pseudomonas aeruginosa in 10 (15.4%). Binary regression analyses found that Gram-negative organisms were significantly more multidrug-resistant than Gram-positive organisms (P = 0.012, OR = 7.172, 95% CI = 1.542–33.352). Patient outcomes included healed ulcers (n = 10, 10.4%), minor amputation (n = 16, 16.7%), major amputation (n = 1, 1%), and debridement (n = 48, 50%). Conclusion: Gram-negative organisms were predominant in patients with diabetes and foot ulcers having clinical signs of infection. Treatment with an individualized antibiotic regimen is vital in ensuring optimal outcomes and preventing major amputations

Knowledge of Diabetic Foot Among Nurses at a Tertiary Hospital in Saudi Arabia

Background: Diabetic foot is the leading cause of hospitalization among patients with diabetes mellitus (DM). Nurses have a significant role in helping diabetic foot patients by educating them about their condition. Therefore, assessing the knowledge of diabetic foot among nurses will help provide better healthcare services to these patients. Objective: This study aimed to assess the knowledge of diabetic foot care among the nursing staff at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia. Methods: This cross-sectional study was conducted at King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia, from March to May 2020. A total of 172 nurses from different departments of the hospital were randomly selected. A validated questionnaire including 68 yes-or-no questions about diabetic foot management was used for the assessment. Results:The average total score of the entire questionnaire was 59 (standard deviation, ±7). During our study, the nursing school curriculum was found to be the major source of knowledge for nurses. Statistical significance (p=0.031) was found for the association between educational background and answers to the risk factor questions. According to our results, most nurses indicated that they believed that reporting any changes to the feet and toes and signs of infection to the physician was the best way to prevent the development of DM foot. Conclusion: Specialized training programs beyond basic nursing education will reinforce knowledge and skills, resulting in an expected lower risk of amputation for DM patients.</jats:p