Background Most paediatric orthopaedic problems referred to paediatric orthopaedists are usually self-limited, requiring observation and reassurance. Higher parental expectations may have resulted in higher referral rates. This study was conducted to assess awareness and knowledge about the diagnosis and management of some common normal variants of musculoskeletal paediatric development among paediatricians and primary health care physicians. Method A self-administered questionnaire (tested for validity and reliability) was distributed between November 2016 and June 2017. Of 300 questionnaires, 189 (63% response rate) were obtained from 106 paediatricians, 57 family physicians, and 26 general practitioners (GPs). Results Paediatricians accounted for 56% of participants, 30.2% were family physicians, and 13.8% were GPs. Correct answer rates ranged between 9% and 66.1%. Inadequate knowledge of common paediatric orthopaedic problems was found in 87.3% of participants. With parental insistence, 75.7% of physicians referred a case, regardless of necessity, whereas inappropriate referral for medicolegal issues was reported by 62.4%. The study showed that paediatricians were less likely than family physicians and GPs to refer inappropriately (67% versus 87.7% and 84.6%, respectively; p = 0.007). Physicians who reported that more than 10% of their training was in orthopaedics were more likely to inappropriately refer orthopaedic cases compared to those who reported a higher percentage of orthopaedic training (82.1% versus 66.7%). Conclusion Inappropriate paediatric orthopaedic referrals are increasing. The results clearly point to the need for increased musculoskeletal education during undergraduate medical and residency training in paediatrics and family medicine. New guidelines should be implemented and updated regularly. Educational material for parents (posters, videos, etc.) should be considered.

Objectives: To measure the prevalence and incidence of pressure ulcers, describe their complications, and identify the proportions of patients followed by the multidisciplinary clinical services at King Abdulaziz Medical City (KAMC) -Jeddah-Saudi Arabia. Methodology:A prospective cohort designed with weekly visits to all general medical and surgical units during the month of August 2016. Patients with new or preexisting pressure ulcers were included. Patients and wounds related variables were followed and recorded weekly. In addition, the clinical disciplines involved in pressure-ulcer's care and their follow-up visits were documented.Results: A total of 370 patients were admitted, and only 21 patients were found to have ulcers. During the total hospital stay for all the patients (2440 days), only 4 new ulcers were developed in the units; the rest developed either at home or in the intensive care unit. The estimated prevalence and incidence of pressure ulcers were 5.7% (95% CI 3.4 -8.0) and 1.6 ulcer/1000 patient-days (95% CI 1.1-2.1) respectively. Sixteen patients, 76%, were bedridden and with urinary catheters. Also, seven patients, 33%, received antibiotics for infected ulcers, and two of them died during the study period due to sepsis. In addition, twenty patients, 95%, were anemic, but only three of them had low body mass index. The proportion of patients, who were seen during the study by dietitians, wound care nurses, occupational therapists and plastic surgery during the study period, was 75%, 33%, 17%, and 17% respectively. Conclusion:Pressure ulcers prevalence and incidence was 5.7% and 1.6 ulcer/1000 patient-days respectively. Majority of pressure ulcer patients were anemic, bedridden, incontinent, and needed home care on hospital discharge. Further research is needed to clarify the best team approach to manage patients with pressure ulcers.