No abstract

Background Medical research is a central part of any residency training. In view of the new Saudi orthopedic committee promotion regulation that mandates each resident to participate in a research project, the challenges that stand in the way of completion of substantial research within surgical residency must be investigated. The aim of this study was to assess the practice, attitudes, perception, and limitations associated with research among residents in the Saudi orthopedic program in the central region. Methods A cross-sectional study was conducted between June and July 2020 using an online-based survey. The total number of study participants was 128 orthopedic residents out of the 191 residents enrolled in the central region program. Data were analyzed, and descriptive statistics in the form of frequency and percentage were determined, analytical tests were performed with P < 0.05 being statistically significant. Results Most residents (95 %) participated in a research project during residency. Most projects (53.10 %) were case reports followed by retrospective studies (48.40 %). The majority (79.70 %) did not attend a research methods course during residency. Experience in research differed significantly (P < 0.05) by age, residency year, and center. The mean involvement score was significantly higher among males at 3 (± 1) than among females at 2 (± 0) (P < 0.001). Only 40.60 % have access to orthopedic journals, and the same percentage (40.60 %) knew how to Critique original articles. There was a statistically significant difference in the accessibility score according to the training center. Lack of faculty support and mentorship were the main barriers to medical research at 62.50 and 39.10 %, respectively. A total of 68.80 % reported that funding was not available through their institutes. Conclusions In Saudi Arabia, the level of meaningful clinical research and publications by orthopedic residents is still low. The results of this study should be taken into consideration before the implementation of the new promotion criteria in the centers under the umbrella of Saudi orthopedic committee.

Introduction: Psoas hematoma is an uncommon complication following spinal surgeries. It has been reported in both extreme lateral interbody fusion (XLIF) and posterior spinal fusion with instrumentation. Minimally invasive techniques are gaining popularity in recent years due to the appealing advantages of reduced operative time, blood loss, hospital stay, and faster recovery. Case Presentation: We are presenting a case of a 77-year-old male with chronic low back pain, diagnosed to have multilevel degenerative disc disease with central and foraminal disc protrusion at L2-L3, L3-L4, L4-L5 with secondary spinal stenosis, underwent XLIF at L3-L4, L4-L5 and then 2nd stage with posterior L3-L5 fusion with pedicle screws. On the fourth day post-operatively, the patient had flank pain and dropping hemoglobin with femoral nerve palsy symptoms, a CT scan revealed a large psoas hematoma. Conservative management was decided on; a follow-up CT scan and examination showed complete resolution of the hematoma and femoral nerve recovery. Discussion: The approach to iliopsoas hematoma post spinal surgeries remains controversial. Iliopsoas hematoma should be suspected in any patients post spinal surgeries even with delayed presentations. The decision to proceed with either surgical intervention or conservative management depends on multiple factors, including patient hemodynamic status, progression of collection and femoral nerve palsy. Conclusion: The exact cause of iliopsoas hematoma post different spinal surgery approaches remains vague. In our opinion, other causes including pre-and post-operative anticoagulants should be investigated. Rushing to drain iliopsoas hematomas in case of femoral nerve palsy might not be the ideal option. Instead, monitoring patient responses to resuscitation and taking a watch and wait approach for femoral nerve palsy might be the proper approach.

The widespread of lower respiratory tract infection by the novel coronavirus (CoV) exploded in December 2019. [1] Nidovirales are enveloped, single-strand-positive RNA viruses that can infect individuals and some creatures. [2] Novel CoV (COVID19), later known as severe acute respiratory syndrome CoV 2, was recognized in December 2019 as cases of pneumonia of unknown etiology in Wuhan City (China). [3][4][5] The World Health Organization (WHO) internationalized the name of the novel CoV into COVID-19. [6] In March, the WHO reported that COVID-19 is a pandemic. [7] Physicians are among the highest risk groups for acquiring COVID-19 infection. [8] This is due to the hazardous nature of their job, which exposes them to infected patients with COVID-19, and many physicians have lost their lives getting infected in hospital settings. [9] Mortalities and morbidities among physicians due to COVID-19 endanger the systems of fighting this pandemic. Physicians can get infected from the hospital and the community, and thus unlike other population groups, they have double sources and chances of infection. In addition to the risk of infection that they are facing, physicians may act as a tool for spreading COVID-19 to patients, families, and communities. [10] The WHO recommends the prevention of COVID-19 spread by protecting physicians and other health-care workers (HCWs).

Al-Rabiah et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.