Role of Multislice Computed Tomography and Local Contrast in the Diagnosis and Characterization of Choanal Atresia

Objective. To illustrate the role of multislice computed tomography and local contrast instillation in the diagnosis and characterization of choanal atresia. To review the common associated radiological findings. Methods. We analyzed 9 pediatric patients (5 males and 4 females) with suspected choanal atresia by multislice computed tomography. We recorded the type of atresia plate and other congenital malformations of the skull. Results. Multislice computed tomography with local contrast installed delineated the posterior choanae. Three patients had unilateral mixed membranous and bony atresia. Three patients had unilateral pure bony atresia. Only 1 of 7 patients have bilateral bony atresia. It also showed other congenital anomalies in the head region. One patient is with an ear abnormality. One patient had congenital nasal pyriform aperture stenosis. One of these patients had several congenital abnormalities, including cardiac and renal deformities and a hypoplastic lateral semicircular canal. Of the 6 patients diagnosed to have choanal atresia, 1 patient had esophageal atresia and a tracheoesophageal fistula. The remaining patients had no other CHARGE syndrome lesions. Conclusions. Local Contrast medium with the application of the low-dose technique helps to delineate the cause of the nasal obstruction avoiding a high radiation dose to the child

Preoperative Imaging Modalities to Predict the Risk of Regional Nodal Recurrence in Well-Differentiated Thyroid Cancers

Abstract Introduction Thyroid cancer incidence has increased in the previous 2 decades. Preoperative identification of lymph node metastasis is a suggested risk factor associated with recurrence following thyroidectomy. Objectives We aimed to evaluate the accuracy of preoperative radiologic investigations of nodal status in determining the postoperative risk of regional nodal recurrence in cases of well-differentiated thyroid cancer. Methods This is a case series. We retrospectively reviewed data, including preoperative ultrasonography and/or computed tomography results, on patients who underwent total thyroidectomy for thyroid cancer at our hospital between 2006 and 2012. Prognostic factors for predicting recurrence, including age, sex, tumor diameter, and nodal diameter, were evaluated. Results Total thyroidectomy was performed on 24 male and 74 female patients (median age, 43 years). The median follow-up time was 21 months. Sixty-eight patients had papillary thyroid cancer, and 30 had follicular cancer. Nodal recurrence was evident in 30% of patients, and 4% of patients died. Identification of lymph node involvement during preoperative radiologic investigations was strongly prognostic for recurrence: 35.3% of patients with positive preoperative ultrasonography findings and 62.5% of those with positive preoperative computed tomography findings had recurrence (p = 0.01). Conclusions Preoperative identification of lymph node metastasis on radiologic studies was correlated with an increased risk of regional nodal recurrence in well-differentiated thyroid cancer. Computed tomography was superior to ultrasonography in detecting metastatic nodal involvement preoperatively and is therefore recommended for preoperative assessment and postoperative follow-up

Comparison of patient safety and quality of care indicators between pre and post accreditation periods in King Abdulaziz University Hospital

Accreditation is an internationally recognized evaluation process used to assess, promote and guarantee efficient and effective quality of patient care and patient safety. This study provides valuable information as to the impact of accreditation in a unique multicultural, multi-language competitive environment at King Abdul-Aziz University Hospital in Saudi Arabia. To achieve an unbiased assessment of the impact of accreditation on quality of patient care and patient safety as perceived by nursing staff. A cross-sectional surveys were conducted pre and post accreditation. A total of 870 registered nurses of 8 different cultural backgrounds from 22 hospital units participated in an electronic accessed surveys. A five point Likert scale was used. For comparison, the pre and post-survey results were statistically analyzed using the McNemar test for testing the significance. A total of 721 nurses answered the survey questionnaire, 675 met the survey criteria. The comparison of percentages of those who answered Agree and Strongly agree pre and post-accreditation items showed post-accreditation improved perception on the quality of patient care and patient safety and promoted good safety practices. Accreditation has an overall statistically highly significant perceived improvement on quality of patient care and patient safety (p<0.001). © Medwell Journals, 2011.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

The impact of accreditation on patient safety and quality of care indicators at King Abdulaziz University Hospital in Saudi Arabia

This study aimed to determine if the accreditation process has a positive impact on patient safety and quality of care. A 4 year retrospective and prospective study design was used. A total of 119 performance indicators were collected through various processes and were lately transformed into 81 patient safety and quality indicators. The numbers and rates of hospital mortality, Healthcare-Associated Infections (HAI), medication errors, cardiopulmonary resucutation codes, surgeries and invasive procedures, blood transfusion reaction and adverse events were the main outcome measures. The following areas had the corresponding number of indicators that were found to be sensitive to Canadian accreditation and that significantly improved post-accreditation: Four indicators of perioperative mortality and rates of neonatal mortality per 100 NICU admissions (p<0.05). Healthcare-associated Infections: sixteen out of twenty-six measured indicators (p<0.05). Blood utilization: one out of two measured indicators, i.e. total number of blood transfusion reactions (p<0.05). Surgeries and invasive procedure: two out of seven measured indicators, i.e. total number of unplanned returns to surgery within 48 h and rate of unplanned returns to surgery per 100 operations (p<0.05). Two out of eight measured indicators, i.e. total number of patients who survived after the first CPR and rate of survival after first CPRper 100 coded patients (p<0.05). Two out of eighteen measured indicators, i.e. rate of pressure ulcers per 1000 admissions and total number of the occurrence variance reports (p<0.05). Accreditation has a positive impact on patient safety and quality of care indicators. © Medwell Journals, 2011.SCOPUS: ar.jinfo:eu-repo/semantics/publishe