Introduction: Quality and safety is an important challenge in healthcare systems all over the world particularly in developing parts. Objective: This survey aimed to assess patient safety culture (PSC) in emergency departments (EDs) in Yemen and identify its associated factors. Methods: A questionnaire containing the Hospital Survey on Patient Safety Culture (HSOPSC) was distributed to ED physicians, nurses, and clinical, and non-clinical staff at three public teaching general hospitals. The percentages of positive responses on the 12 patient safety dimensions and the summation of PSC and two outcomes (overall patient safety grade and adverse events reported in the past year) were assessed. Factors associated with PSC aggregate score were analyzed. Results: finally, out of 400 questionnaires, 250 (64%) were analyzed. In total, 207 (82.3%) participants were nurses and physicians; 140 (56.0%) were male; 134 (53.6%) were less than 30 years old; and 134 (53.6%) had a university degree. Participants provided the highest ratings for the “teamwork within units” PSC composite (67%). The lowest rating was for “non-punitive response to error” (21.3%). A total of 120 (48.1%) participants did not report any events in the past year and 99 (39.7%) gave their hospital an “excellent/very good” overall patient safety grade. There were significant differences between the hospitals’ EDs in the rating of “handoffs and transitions” (p=0.016), “teamwork within units” (p=0.018), and “frequency of adverse events reported” (p=0.016). Staff working in intensive care units (8.4%, n=21) had lower patient safety aggregate scores. Conclusions: PSC ratings appear to be low in Yemen. This study emphasizes the need to create and maintain a PSC in EDs through the implementation of quality improvement strategies and environment of transparency, open communications, and continuous learning.

Background/Aim This study aimed to report a rare case of erythroderma or exfoliative dermatitis as a paraneoplastic syndrome of prostate adenocarcinoma. Exfoliative dermatitis is a rare inflammatory skin condition that is characterized by desquamation and erythema involving more than 90% of the body surface area. It is a clinical manifestation and usually associated with various underlying cutaneous disorders, drug induced reactions and malignancies. Case Report: Herein we report a case of 55-year-old male patient who presented with progressively diffuse scaling and erythematous rash of 3 months duration. He was diagnosed with untreated prostate adenocarcinoma about 2 months prior his admission. Skin biopsy confirmed exfoliative erythroderma diagnosis. He was investigated extensively for other pathologies, however all work up remained negative except a CT finding of large heterogeneous prostate gland with elevated PSA which was consistent with prostate cancer. Daily oral prednisone for one week and hydrocortisone cream provided partial clinical improvement. The patient was discharged on tapering steroid to follow-up with urology and oncology for further underlying prostate carcinoma management. Conclusion: We concluded that the ongoing erythroderma was a paraneoplastic syndrome of prostate adenocarcinoma. Hence, early detailed history and routine screening of malignancy-related biomarkers is warranted on any individuals presenting with such symptoms.

Intravesical instillation of Bacillus Calmette-Guerin is one of the standard treatment options for superficial bladder cancer. While Bacillus Calmette-Guerin therapy is usually well tolerated with most patients experiencing only cystitis, in rare cases, it can lead to disseminated granulomatous disease. We present a case of a 72-year-old man with disseminated granulomatous disease from intravesical BCG instillation whose treatment was complicated by antimycobacterial drug toxicity.

No abstract