BackgroundGlobally, less than 10% of graduating medical students select pathology as a future career. Many factors were reported from different settings to influence the choice of pathology. The aim of this study was to investigate the factors that determine medical students' preferences in choosing pathology as a future career. MethodsThis cross-sectional study surveyed students from three governmental medical schools in Riyadh, Saudi Arabia. A self-administered questionnaire that contained demographic questions and items that addressed perceived factors that affect the choice of pathology was distributed to medical students. Collected data were analyzed using Statistical Product and Service Solutions (SPSS) Statistics for Windows, Version 25.0 (Armonk, NY: IBM Corp). A chi-square test was used to determine the association between independent variables and interest in pathology. ResultsOut of the 400 questionnaires distributed, 338 students completed the survey with a response rate of 84.5%. Overall, surgery (24%) and internal medicine (20%) were the most favored, specialties with only 5% of the students selecting pathology as their first choice. Patient-doctor interaction (72.2%) was perceived as the most important factor in not choosing pathology as a future career. Taking an elective course, younger age groups, and year in medical school were all significantly associated (p<0.001) with an interest in pathology. ConclusionIn this study, most of the students indicated surgery and internal medicine as their first specialty choices. Only 5% of the students chose pathology as their first choice. Two-thirds of medical students perceived pathologists do not interact with patients. A significant association was found between younger age groups, enrolling for a pathology course, and having an interest in pathology.
Background Pulmonary embolism (PE) is a known cause of morbidity and mortality. A diagnosis of PE is made by computed tomography pulmonary angiogram (CTPA) or a ventilation-perfusion (V/Q) scan. This study aimed to assess the incidence and predictors of acute kidney injury (AKI) in patients with suspected PE. Methods This study was a retrospective study including patients with suspected PE who underwent a CTPA and/or a V/Q scan from 2015 to 2020. The patients were grouped into CTPA or V/Q scan. Creatinine levels were obtained before and after the procedure. AKI was defined based on an increased serum creatinine by 0.3 mg/dL within 48 hours. Results A total of 752 patients were included in the study. The majority (n = 688) underwent a CTPA as a diagnostic modality in patients suspected to have pulmonary embolism (PE), and a V/Q scan was used in 73 patients. Of the 752 patients, there were eight patients who underwent both diagnostic modalities. PE was diagnosed in 121 (16.1%) patients. The incidence of AKI was observed in 15.8%. PE was suspected more frequently in the female group (n = 481, 64%), with a 50% reduction of AKI risk, compared with the male group (p-value = 0.004, OR = 0.522, 95% CI = 0.337-0.81). The presence of diabetes mellitus (DM) and hypertension (HTN) was associated with AKI (p-value < 0.001). Of the AKI group, 43 (36.1%) patients had malignancy. The presence of malignancy was a predictor of increased AKI risk (p-value = 0.014, OR = 1.74, 95% CI = 1.21-2.70). A small proportion (2.1%, n = 16) required dialysis. Patients who developed AKI had a 30-day mortality of 20.2% compared with 5.1% for the group without AKI. Conclusion In our sample, clinicians suspected PE more frequently in the female group. The overall incidence rate of AKI in patients suspected of having PE was 16.1%. The presence of diabetes mellitus and hypertension was associated with AKI. However, DM and HTN were not predictors of AKI. The risk of AKI requiring dialysis was relatively low (2.1%). There was no relationship between the diagnostic modalities and PE, and AKI, suggesting that clinicians overestimate the fear of contrast-induced AKI (CI-AKI).
BackgroundIncisional hernia post organ transplant increases morbidity and impacts quality of life among patients undergoing abdominal organ transplants. ObjectivesTo estimate the incidence rate of incisional hernia and the factors associated with incisional hernia among patients who underwent liver and kidney transplants. MethodsThis was a retrospective cohort study in which all patients from 2015 to 2020 who underwent liver and/or kidney transplants and met inclusion criteria were involved. ResultsA total of 424 patients who received transplantation surgery were included. Out of them, 287 patients (67.6%) underwent kidney transplants while 132 patients (31.1%) underwent a liver transplant. Additionally, five patients (1.1%) received both liver and kidney transplantation. Fourteen patients (3.3%) experienced incisional hernia across all samples. A higher incidence rate was noticed among patients with liver transplants compared to kidney transplants (6.81% in the liver group vs 1.7% in the kidney group), which showed a statistical significance between the two groups (P-value= 0.007). In multivariate analysis, surgical site infection (SSI), donor type, acute organ rejection, mycophenolate mofetil (MMF), and diabetes were all not predictors of incisional hernia among the patients. ConclusionIncisional hernia incidence in between the groups was within the global range of incisional hernia incidence among abdominal organ transplant patients, with a higher incidence among liver transplant patients. All factors associated with incisional hernia, such as SSI, DM, and old age, didn't show significance as predictors to incisional hernia formation among the samples.
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