BACKGROUND AND OBJECTIVESThis study is to determine level and factors associated with burnout among physicians in a tertiary hospital in Saudi Arabia.DESIGN AND SETTINGSThis is a cross-sectional study, conducted at the King Fahad National Guard Hospital at in King Abdulaziz Medical City between October 2010 and November 2010.METHODSThe Maslach Burnout Inventory questionnaire was used to measure burnout. Socio-demographic-, specialty-, and work-related characteristics were added to explore factors associated with burnout.RESULTSThe study included 348 participants; 252 (72%) were males, 189 (54%) were consultants, and 159 (46%) were residents. The mean (SD) age was 35 (9.8) years. The burnout prevalence was 243/348 (70%); 136 (56%) of the 243 were residents and 107 (44%) were consultants. Age, female gender, marital status, number of years in practice, sleep deprivation, presence of back pain, and a negative effect of practice on family life were associated with burnout in the univariate logistic regression analysis. The factors independently associated with burnout in the final multivariate model were as follows: suffering from back pain (odds ratio [OR]=2.1, 95%CI 1.2–3.8, P=.01), sleep deprivation (OR=2.2, 95%CI 1.2–3.8, P=.009), being a resident physician/surgeon (OR=4.9, 95%CI 1.7–14.2, P=.004), and negative effect of practice on family life (OR=2.1, 95%CI 1.1–3.9, P=.02).CONCLUSIONIn this study, the prevalence of burnout was found to be higher than estimates documented in most other studies. Reported risk factors should be addressed to decrease the prevalence and consequences of burnout.

Surgical site infection (SSI) is disastrous in orthopedic practice as it is difficult to rid the bone and joint of the infection. This study was aimed to assess the prevalence of SSI in orthopedic practice and to identify risk factors associated with surgical site infections. All patients admitted to the orthopedic male and female wards between January 2006 and December 2011 were included in the study group. The data, which were collected from the medical charts and from the QuadraMed patient filing system, included age, sex, date of admission, type of admission (elective versus emergency), and classification of fractures. Analyses were made to find out the association between infection and risk factors, the χ2 test was used. The strength of association of the single event with the variables was estimated using Relative Risk, with a 95% confidence interval and P < 0.05. A total of 79 of 3096 patients (2.55%) were included: 60 males and 19 females with the average age of 38.13 ± 19.1 years. Fifty-three patients were admitted directly to the orthopedic wards, 14 were transferred from the surgical intensive care unit, and 12 from other surgical wards. The most common infective organism was Staphylococcus species including Methicillin Resistant Staphylococcus aureus (MRSA), 23 patients (29.11%); Acinetobacter species, 17 patients (21.5%); Pseudomonas species, 15 patients (18.9%); and Enterococcus species, 14 patients (17.7%). Fifty-two (65.8%) had emergency procedures, and in 57 patients trauma surgery was performed. Three (3.78%) patients died as a result of uncontrolled septicemia. SSI was found to be common in our practice. Emergency surgical procedures carried the greatest risk with Staphylococcus species and Acinetobacter species being the most common infecting organisms. Proper measures need to be undertaken to control infection rates by every available method; antibiotics alone may not be sufficient to win this war.

BACKGROUND AND OBJECTIVESOsteoporosis is common in Saudi Arabia and the burden of management in an aging population will increase in coming decades. There is still no national policy nor consensus on screening for this silent disease. The objective of this analysis was to determine from the published data the prevalence of osteopenia and osteoporosis in Saudi Arabians, the prevalence of secondary osteoporosis, and the prevalence of osteoporosis-related fractures (ORF). We also sought to determine the best age to begin and best modality for screening.METHODSData Sources were MEDLINE (1966 to May 2011), EMBASE (1991 to May 2011), the Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews (1952 to May 2011), and the Science Citation Index (1966 to May 2011), published data from the Saudi Medical Journal (1985–2011) and Annals of Saudi Medicine (1985–2011). We selected English-language articles with at least 100 Saudi individuals. Two authors independently reviewed articles and abstracted data.RESULTSThe authors identified 36 potentially relevant articles, of which 24 met the inclusion criteria. Of 5160 healthy women 50 to 79 years of age (mean, SD: 56.8 [2.7]), 36.6% (6.6%) were osteopenic and 34.0% (8.5%) were osteoporotic. In three studies on males (n=822), the prevalence of osteopenia was 46.3% and osteoporosis 30.7%. Males had a significantly higher frequency of osteopenia in comparison to females (P=<.001 95% CI<−0.0333), The mean age of the patients with secondary osteoporosis was 37.4 (13.5, 18–57) years, with the osteoporosis in 46.4% and osteopenia in 34.1%. In 5 studies of ORF, the incidence of vertebral fractures was between 20%–24%.CONCLUSIONThe currently available literature on Saudi Arabian population suggests that the ideal age for screening for low bone mass among the Saudi population should be earlier (55 years) than the ≥65 years in Western countries. Both quatitative ultrasound and dual-energy x-ray absorptiometry could be used for screening. The relatively small number of studies on Saudi Arabians and the different machines used for diagnosis limited the authors ability make conclusions with surety.

BACKGROUND AND OBJECTIVES:The effects of vitamin D on bone mass remain to be understood. This study was conducted with the objective of evaluating the influence of 25-hydroxyvitamin D (25OHD) levels on bone mineral density (BMD) among Saudi nationals.DESIGN AND SETTING:Cross-sectional study carried out at university hospital from 1 February 2008 to 31 May 2008.SUBJECTS AND METHODS:Healthy Saudi men and women in the peak bone mass (PBM) age group and those aged ≥50 years were recruited from the outpatient department of King Fahd University Hospital, Al Khobar, Saudi Arabia, between February 1, 2008, and May 31, 2008. Patient age and sex were documented, and body mass index was calculated. Hematological, biochemical, and serum 25OHD tests were performed. BMD was determined by dual-energy x-ray absorptiometry of the upper femur and lumbar spine. Patients were divided into three groups, based on their 25OHD level.RESULTS:Data from 400 patients were analyzed. Among individuals with a normal 25OHD level, 50% of women and 7% of men in the PBM age group and 26.4% of women and 49.2% of men aged ≥50 years had low bone mass. In patients with 25OHD insufficiency, 84.2% of women and 88.9% of men in the PBM age group and 83.3% of women and 80% of men aged ≥50 years had low bone mass. Results for patients with 25OHD deficiency revealed that none of the men and women in the PBM age group or ≥50 years old had normal BMD. Significant positive correlations between 25OHD level and BMD and significant negative correlations with parathyroid hormone were shown in most of the groups.CONCLUSIONS:This study showed that the vitamin D level significantly influences BMD reading among Saudi individuals. Evaluation and treatment of hypovitaminosis D should be considered during management of low bone mass.