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Perceptions of emergency medicine residents on the quality of residency training in the United States and Saudi Arabia

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World Journal of Emergency Medicine 2018年第1期9卷 5-12页

作者： Ahmad Aalam Mark Zocchi Khalid Alyami Abdullah Shalabi Abdullah Bakhsh Asaad Alsufyani abdulrahman sabbagh Mohammed Alshahrani Jesse M.Pines Department of Emergency Medicine King Abdulaziz University Department of Emergency Medicine The George Washington University Center for Healthcare Innovation and Policy Research The George Washington University Department of Pediatrics University of Dammam Department of Emergency Medicine King Abdulaziz Medical City National Guard Hospital Department of Emergency Medicine University of Toledo Department of Emergency Medicine King Fahad Medical City

BACKGROUND: We compare educational environments(i.e. physical, emotional and intellectual experiences) of emergency medicine(EM) residents training in the United States of America(USA) and Saudi Arabia(SA).METHODS: A cross-sectional survey study was conducted using an adapted version of the validated Postgraduate Hospital Educational Environment Measure(PHEEM) survey instrument from April 2015 through June 2016 to compare educational environments in all emergency medicine residency programs in SA and three selected programs in the USA with a history of training Saudi physicians. Overall scores were compared across programs, and for subscales(autonomy, teaching, and social Support), using chi-squared, t-tests, and analysis of ***: A total of 219 surveys were returned for 260 residents across six programs(3 SA, 3 USA), with a response rate of 84%. Program-specific response rates varied from 79%–100%. All six residencies were qualitatively rated as "more positive than negative but room for improvement". Quantitative PHEEM scores for the USA programs were significantly higher: 118.7 compared to 109.9 for SA, P=0.001. In subscales, perceptions of social support were not different between the two countries(P=0.243); however, role autonomy(P<0.001) and teaching(P=0.005) were better in USA programs. There were no significant differences by post-graduate training ***: EM residents in all three emergency medicine residency programs in SA and the three USA programs studied perceive their training as high quality in general, but with room for improvements. USA residency programs scored higher in overall quality. This was driven by more favorable perceptions of role autonomy and teaching. Understanding how residents perceive their programs may help drive targeted quality improvement efforts.

关键词： Emergency medicine residents Residency training United States of America Saudi Arabia

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The interplay mechanism between IDH mutation, MGMT-promoter methylation, and PRMT5 activity in the progression of grade 4 astrocytoma: unraveling the complex triad theory

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Oncology Research 2024年第6期32卷 1037-1045页

作者： MAHER KURDI ALAA ALKHOTANI abdulrahman sabbagh EYAD FAIZO AHMED I.LARY AHMED K.BAMAGA MAJID ALMANSOURI BADR HAFIZ THAMER ALSHARIF SALEH BAEESA Department of Pathology Faculty of MedicineKing Abdulaziz UniversityRabighSaudi Arabia Department of Pathology College of MedicineUmm Al-Qura UniversityMakkahSaudi Arabia Department of Surgery Faculty of MedicineKing Abdulaziz UniversityJeddahSaudi Arabia Department of Surgery Faculty of MedicineUniversity of TabukTabukSaudi Arabia Section of Neurosurgery Department of SurgeryKing Abdulaziz Medical CityJeddahSaudi Arabia Department of Pediatrics Faculty of MedicineKing Abdulaziz UniversityJeddahSaudi Arabia Department of Clinical Biochemistry Faculty of MedicineKing Abdulaziz UniversityJeddahSaudi Arabia Department of Neurosciences King Faisal Specialist Hospital and Research CenterJeddahSaudi Arabia Department of Surgery King Abdulaziz Specialist HospitalTaifSaudi Arabia

Background:The dysregulation of Isocitrate dehydrogenase(IDH)and the subsequent production of 2-Hydroxyglutrate(2HG)may alter the expression of epigenetic proteins in Grade 4 *** interplay mechanism between IDH,O-6-methylguanine-DNA methyltransferase(MGMT)-promoter methylation,and protein methyltransferase proteins-5(PRMT5)activity,with tumor progression has never been ***:A retrospective cohort of 34 patients with G4 astrocytoma is classified into IDH-mutant and IDH-wildtype *** groups were tested for MGMT-promoter methylation and PRMT5 through methylation-specific and gene expression PCR ***-cohort statistical significance was ***:Both IDH-mutant WHO grade 4 astrocytomas(n=22,64.7%)and IDH-wildtype glioblastomas(n=12,35.3%)had upregulated PRMT5 gene expression except in one *** of the 22 IDH-mutant tumors,10(45.5%)tumors showed MGMT-promoter methylation and 12(54.5%)tumors had unmethylated *** IDH-wildtype tumors had unmethylated *** was a statistically significant relationship between MGMT-promoter methylation and IDH in G4 astrocytoma(p-value=0.006).Statistically significant differences in progression-free survival(PFS)were also observed among all G4 astrocytomas that expressed PRMT5 and received either temozolomide(TMZ)or TMZ plus other chemotherapies,regardless of their IDH or MGMT-methylation status(p-value=0.0014).Specifically,IDH-mutant tumors that had upregulated PRMT5 activity and MGMT-promoter methylation,who received only TMZ,have exhibited longer ***:The relationship between PRMT5,MGMT-promoter,and IDH is not ***,accumulation of D2-hydroxyglutarate(2-HG),which partially activates 2-OG-dependent deoxygenase,may not affect their *** IDH-wildtype glioblastomas,the 2HG-2OG pathway is typically inactive,leading to PRMT5 *** alone,compared to TMZ-plus,can increase PFS in upregulated PRMT5 ***,using a PRMT5 inhibitor in G4

关键词： Grade 4 astrocytoma Glioblastoma Isocitrate dehydrogenase(IDH) O-6-methylguanine-DNA methyltransferase(MGMT) Protein methyltransferase proteins-5(PRMT5) Progression-free survival(PFS)

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Duration of Preoperative External Ventricular Drain in Pediatric Posterior Fossa Tumors—Does It Matter?

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Open Journal of Pediatrics 2017年第2期7卷 86-97页

作者： Ehtesham Ghani Ayman AlBanyan abdulrahman sabbagh Maqsood Ahmad Department of Pediatric Neurosurgery National Neuroscience Institute King Fahad Medical City Riyadh KSA

Objective: Aim of the study was to assess the duration of preoperative external ventricular drain (EVD) as a predictor for permanent cerebrospinal fluid (CSF) diversion in pediatric posterior fossa tumors. Methods: The study was conducted in the Department of Pediatric Neurosurgery, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia from January 2010 to December 2013. The data were collected retrospectively. The patients who had emergency insertion of external ventricular drain (EVD) due to hydrocephalus before the definitive posterior fossa tumor surgery were included in the study. Results: The preoperative emergency insertion of EVD was done in 38 patients with pediatric posterior fossa tumors. The patients were divided into two groups. Group A consists of those patients who had duration of preoperative EVD equal or less than 7 days. Group B includes those patients who had duration of preoperative EVD more than 7 days. Group A has 16 patients while Group B has 22 patients. The predominant clinical feature was symptoms and signs of raised intracranial pressure (ICP) only. Infection related to EVD was seen in seven patients. Ventriculoperitoneal (VP) shunt was required in 31.25% of Group A patients and 18.18% of Group B patients (p value = 0.35). Overall shunt rate was 23.68%. Conclusion: There are well known number of factors that can determine the need of permanent CSF diversion in patients with posterior fossa tumors. However, there is no effect of preoperative duration of EVD in determining the requirement of postoperative VP shunt.

关键词： Posterior Fossa Tumors External Ventricular Drain Hydrocephalus Ventriculoperitoneal Shunt CSF Diversion

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Clinicopathological features and treatment outcomes of brain stem gliomas in Saudi population

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World Journal of Clinical Oncology 2014年第5期5卷 1060-1067页

作者： Yasser Bayoumi abdulrahman J sabbagh Reham Mohamed Usama M El Shokhaiby Ahmed Marzouk Maklad Mutahir A Tunio Ali Abdullah O Balbaid Consultant Radiation Oncology Comprehensive Cancer Center King Fahad Medical City Riyadh-59046 Saudi Arabia Radiation Oncology NCI Cairo University Cairo 11435 Egypt Neurosurgery King Fahad Medical City Riyadh-59046 Saudi Arabia Radiation Oncology NCI Cairo University Cairo 11435 Egypt Clinical Oncology Sohag University Sohag 11432 Egypt Radiation Oncology Comprehensive Cancer Center King Fahad Medical City Riyadh-59046 Saudi Arabia

AIM: To analyze experiences to identify treatment outcomes and prognostic factors in a Saudi ***: Medical records of patients with brainstem gliomas treated from July 2001 to December 2012 were reviewed to identify treatment outcomes of surgery, radiation therapy and chemotherapy and associated prognostic factors in a Saudi ***: We analyzed 49 brain stem glioma(BSG) patients from July 2001 to December 2012; 31 of them were males(63.3%) with a median age of 12.6 years(range: 8-64 mo). Twenty-two patients(44.9%) had diffuse intrinsic pontine gliomas(DIPG) and 15(30.6%) presented with focal/tectal BSG. Histopathology was available in 30 patients(61.2%). Median survival time for the whole cohort was 1.5 years. One and two year OS rates were 51.1% and 41.9% respectively. Two year OS rates for focal/tectal, dorsally exophytic, cervicomedullary and DIPG tumors were 60%, 33.3%, 33.3% and 13.6% respectively(P 18 years) P = 0.01, KPS < 70 P = 0.02, duration of symptoms(< 60 d) P = 0.002, histology(better for favorable) P = 0.002, surgery(maximal resection) P = 0.002, and concurrent chemotherapy with radiation therapy in DIPG(better if given) P = ***: BSG, especially the DIPG subgroup, had a dismal prognosis, needing more aggressive neurosurgical, radiation and chemotherapy techniques, while focal and tectal tumors were found to have a better prognosis.

关键词： Brain stem glioma Children Adults Saudi Arabia Treatment outcomes

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