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Mir Sadat-Ali

Publications and source records attributed to Mir Sadat-Ali.

14 recordsLinked to original sources
PubMed2006

Is early mortality related to timing of surgery after fracture femur in the elderly?

OBJECTIVE: The purpose of this study is to review the outcome of fracture femur in elderly patients (>65 years), and to identify cause or causes of mortality. METHODS: Between January 1996 and December 2002, 115 patients over 65 years were admitted and operated at King Fahd University Hospital, Al-Khobar. Fifty-six of patients suffered with femoral fractures. Demographic data collected included age, gender, site of fracture, co-morbidities, delay in surgery, duration of surgery, implant used and Anesthesia Society of America scoring (ASA). A minimum follow up of 12 months was considered important for inclusion in the study. Patients remained alive were assessed for their functional independence. RESULTS: The data of 48 patients were gathered for analysis. There were 31 males and 17 females with a mean age of 76.5 years (age range 65-101 years). The mean follow up was 32.8 months (12-84 months +/- SD 17.81). There were 32 fractures of the trochanteric area. The average delay in surgery was 112 hours (24-280 hours). At the end of 24 months: 13 (27%) were dead and 28 (80%) were functionally independent similar to pre-injury status. There was statistical significance between the ASA score and the mortality (p<0.005). However, mortality significantly higher in patients who underwent surgery under general anesthesia p<0.05. CONCLUSION: Our data indicate that the mortality in the elderly is not related to the delay in surgery. The significant factors to early demise of patients were high ASA score, and the type of anesthesia used during surgery.

Age Factors↗
PubMed2006

Diabetes mellitus and male osteoporosis. Is there a relationship?

OBJECTIVE: To evaluate the relationship between male osteoporosis and type 2 diabetes mellitus (DM). METHODS: We screened 154 male Saudi Arabian patients over the age of 50 years for osteoporosis between May and December 2005, at the Endocrine and Orthopedic Clinics of King Fahd University Hospital, Al-Khobar, Kingdom of Saudi Arabia. Patients body mass index was calculated. Fasting blood glucose was measured in all patients. All patients with type 2 DM hemoglobin A1c levels were measured at follow up. All had bone mineral density (BMD) measurement of hip area and the lumbar spine using the dual energy x-ray absorptiometry scan, and osteoporosis and osteopenia was assessed on the basis of the World Health Organization guidelines. The data was entered in the database and analyzed using the Statistical Package for Social Sciences software with statistical significance of <0.05 and a confidence interval of 95%. RESULTS: There were 57 patients in group A (type 2 DM) with an average age of 59.76 years, 34 in group B (impaired fasting glucose) with an average age of 60.90 years and 63 in group C (normal glucose level), with an average age of 62.53 years. Bone mineral density analysis revealed 10 patients (17.5%) in group A, 7 (20%) in group B and 12 (19%) in group C were normal. Analysis did not show any statistical significance among the 3 groups with regard to BMD, T-Score and Z-Score. CONCLUSION: The study indicates that the prevalence of osteopenia and osteoporosis is common among the Saudi Arabian males. The presence of type 2 diabetes mellitus in these patients did not influence or increase the incidence of osteopenia or osteoporosis.

Absorptiometry, Photon↗
PubMed2005

Are orthopedic surgeons prone to burnout?

OBJECTIVE: Burnout syndrome (BOS) is a state of physical, and emotional or mental exhaustion, depersonalization, and low personal accomplishment. Health care givers are most prone to suffer from BOS. There are no studies to date on BOS among trained orthopedic, and trauma surgeons. The objective of this study, was to assess the prevalence of BOS among the orthopedic surgeons in the Eastern province of Saudi Arabia. METHODS: This study was conducted among the orthopedic surgeons of the Eastern province of Saudi Arabia between September 2003 and October 2004. One hundred and two questionnaires of the Maslach Burnout Inventory (MBI) were sent to the qualified orthopedic surgeons with a self-addressed stamped envelope, from the Department of Orthopedic Surgery, King Fahd Hospital of the University, Al-Khobar. Three factors of MBI, which were assessed, were emotional exhaustion, depersonalization, and personal accomplishment. The data were entered in the database, and analyzed using Statistical Package for Social Science. RESULTS: Sixty-nine (67.6%) of the orthopedic surgeons completed the questionnaire. The average age was 45.72 +/- 6.82 (33-57) years. Thirty-five (50.7%) were found to be in a state of emotional exhaustion, 59.4% depersonalized, and 17% had low state of personal accomplishment. Doctors working in the government hospitals fared better than those in the private sector. CONCLUSION: Burnout syndrome is common among orthopedic surgeons working in the Eastern province Saudi Arabia. It is emphasized that awareness of the problem should be highlighted; programs need to be put in place to reduce the prevalence of burnout syndrome.

Adult↗
PubMed2005

Effect of parity on bone mineral density among postmenopausal Saudi Arabian women.

OBJECTIVE: Osteoporosis and osteopenia among postmenopausal Saudi Arabian women are common to the extent of over 60%. Pregnancy, multiparity and prolonged lactation are suggested as factors modifying negatively in the development of osteoporosis. Earlier reports from the institution indicated a beneficial role of multiparity in postmenopausal osteoporosis (PMO). We conducted this study to measure the effect of parity on bone mineral density (BMD) measurement of lumbar spine and the upper femur. METHODS: We conducted this prospective study at King Fahd Hospital of the University, College of Medicine, King Faisal University, Dammam, Saudi Arabia, between January 2002 and June 2003. This study analyzed 256 patients who attended orthopedic clinics. The data gathered was age, duration of menopause, number of children borne, height and weight for body mass index (BMI) calculation. We excluded women with secondary osteoporosis from the study. We entered the patients orthopedic complaints in the database. We carried out the BMD measurements using Hologic total body DEXA machine. We analyzed the data using SPSS package with significance at p<0.05 and confidence interval of 95%. For final analysis, we took into consideration an average of results of the lumbar spine and hip region. RESULTS: We analyzed the available data of 256 patients. We divided the patients into 2 groups; group A with >6 children and group B with women of <5 children. In group A, there were 116 women and 140 in group B. The mean age of patients in group A was 56.81 (50-65) years SD +/- 5.19 and in group B the mean age was 58.86 years (48-76) SD +/- 7.68. The average BMI in group A was 31.95 kg/m2 and in group B it was 29.14 kg/m2. The BMD of the lumbar spine of group A was 0.850 g/cm2 (SD+/-0.112) compared to group B of 0.699 g/cm2 (SD+/-0.141), p<0.005. The BMD of the hip region of group A was 0.836 g/cm2 and that of group B patients was 0.716g/cm2 (p<0.01). In women with <5 children, 25.5 had normal BMD as compared to 47 in women with >6 children, 25.4% were osteoporotic in group A and in group B 48%. As per the World Health Organization classification 56% in group A had an increased risk of fracture as compared to 77.5% in group B women. CONCLUSION: Our results indicate that women who had borne >6 children were less osteoporotic and of low fracture risk as compared to those women who had <5 children. The BMD of the women with >6 children was statistically higher than their counterparts, and they sustain this after prolonged lactation. We believe that increased parity protects women from osteoporosis and the severity of the disease, and it is our suggestion that women with <5 children and those nulliparous, who are at increased risk of developing osteoporosis should be investigated and treated accordingly.

Absorptiometry, Photon↗
PubMed2004

Unusual cause of carpal tunnel syndrome: a case report.

An unusual case of compression of median nerve at the wrist is described due to a foreign body. In unusual presentation of carpal tunnel syndrome, ultrasonography of the wrist is recommended to rule out a foreign body in the region.

Adult↗
PubMed2004

Bone mineral density among postmenopausal Saudi women.

OBJECTIVE: Osteoporosis is reported to be common among postmenopausal Saudi women. The reported incidence varies between 50-60%. Different machines were used to reach these conclusions. At present it is believed that dual energy x-ray absorptiometry (DEXA) is the most accurate method to diagnose osteoporosis. This study was conducted to measure bone mineral density (BMD) measurement of lumbar spine and the upper femur of Saudi postmenopausal women attending orthopedic clinic with unrelated complaints. METHODS: This study comprises of 256 patients attending orthopedic clinics at the King Fahd Hospital of the University, Al-Khobar, Kingdom of Saudi Arabia between January 2002 and June 2003. The data gathered was age, duration of menopause, height and weight for body mass index (BMI) calculation. Women with secondary osteoporosis were excluded from the study. Patients' orthopedic complaints were also recorded in the database. Bone mineral density measurements were carried out using Hologic total body DEXA machine. The data were analyzed using SPSS package. RESULTS: The data of 256 patients was available for analysis. The average age of patients screened was 57.62 years (49-76) SD +/- 6.71. The BMI was 21.3-42.9 Kg/m2 (SD +/- 5.34). The BMD of the lumbar spine was 0.785 gm/cm2 (0.527-1.023) SD +/-0.142 and that of the hip region was 0.764 gm/cm2 (0. 500-1.069) SD +/- 0.149. As per the WHO classification 59 women (23%) were classified as normal with T score of -0.82, 78 (30.5%) as osteopenic with T score -2.5 and 119 (46.7%) as osteoporosis with T score -3.58. When the BMD of the hip was analyzed 62 (24.2%) were normal T score -1.0, 81 (31.6%) as osteopenic, T score -2.5 and 113 (44.1%) as osteoporotic, with a T score of -3.1. On the basis of analysis of the lumbar spine 190 (74.2%) had increased risk of fracture as compared to the analysis of hip 59% were at increased risk of fracture. CONCLUSION: Our results indicate that postmenopausal Saudi women suffer from osteoporosis and osteopenia higher than those from other parts of the country. Necessary steps are needed so as to avoid osteoporosis and its complications which could end up in epidemic proportions.

Absorptiometry, Photon↗
PubMed2003

Birth associated trauma.

OBJECTIVE: To assess the incidence of birth-injuries seen at the King Fahd Hospital of the University, Al-Khobar, Kingdom of Saudi Arabia (KSA). METHODS: A retrospective analysis was carried out in 31,028 consecutive deliveries between January 1986 and December 1996 at the King Fahd Hospital of the University, Al-Khobar, KSA. The study group was compared with a matched control group. RESULTS: There were 203 newborns with 208 injuries with an incidence of 6.70 per 1,000 live births. The majority (55%) of the injuries was sustained during normal vaginal deliveries and the least were during cesarean section (5.2%). The average gestational age was 39 weeks (25-44 weeks) in the study group and in the control group was 38.84 (21-44 weeks). The birth weight in the study group was 3323 gms (780-6190) and the control group was 3015 gms (790-6,015) p<0.01. The Apgar score in the study group was 7 and 9 at one and 5 minutes and in the control group was 8 and 9. There were 104 scalp injuries, 50 nerve injuries, 20 fractures (11 clavicle and 9 long bones) and 21 newborns had intracranial hemorrhage. CONCLUSION: This study demonstrates a variety of birth related trauma at the teaching institution with a lower overall incidence as compared to reports from the literature. The only significant factor was that birth weight was higher in the study group as compared to the control group (p <0.01). It is recommended that every effort be required to further decrease the incidence of birth injuries.

Birth Injuries↗
PubMedDate not supplied

Glove perforation in pediatric orthopedic practice.

A prospective study was conducted to assess the glove perforation rate during 100 consecutive pediatric orthopedic operations. Eight hundred fifty-four gloves were tested for perforations. The overall glove perforation rate was 8.43%. Assistant surgeons had a rate of 45.8%, surgeons 33.4%, and scrub nurses 20.8%. More perforations were noticed on the left glove; the thumb and index finger were the most common sites of perforation. The duration of surgery was significantly related to the perforation rate. Two patients had postoperative wound infections and the gloves of surgeons and assistant surgeons were found to be perforated. Every attempt needs to be made to reduce the risk of glove perforation.

Equipment Failure↗
PubMedDate not supplied

Double or single gloves: which is safer in pediatric orthopedic surgery.

BACKGROUND AND AIM: Surgical gloves should form an efficient barrier between surgeons and patients to prevent cross infection. Single gloves (SGs) have long been reported unsafe, and usage of double gloves (DGs) is still not universal. No study has reported the usage of DGs in pediatric orthopedic operations. The aim of this study was to assess the efficacy of DGs versus SGs in prevention of body fluid contact between patients and surgeons during pediatric orthopedic surgery. METHODOLOGY: After 150 pediatric orthopedic operations, DGs and SGs were collected and tested for perforations. Gloves were tested for size, site, and number of perforations among principal surgeons, assistant surgeons, and scrub nurses. Gloves were not changed during long surgical procedures and were changed only if perforations were identified and recorded. The DGs used were Maxitex Duplex, powder-free indicator gloves and the SGs were of Gammex-Ansell. One hundred unused gloves of each group were tested as controls. Medical records of the patients were reviewed for age, sex, type of operation, duration of operation, and any postoperative wound infection. The data were entered in database and analyzed using SPSS package. The data were compared between double and SGs using t test with a level of statistical significance at P less than 0.05. RESULTS: Five hundred twenty-six DGs and 316 SGs were tested. Forty-three perforations were detected in DGs (8.1%). Outer gloves were breached in 7.8% and inner in 0.3% as compared with SGs in which 28 (8.7%) were perforated. In DGs, 4% had multiple perforations compared with 11.9% in SGs. There was a statistical significance (P<0.001) when the perforations of inner gloves were compared with the SGs. None of the inner perforations were recognized during surgery, but the outer gloves of the DGs were recognized in 71% as compared with 9% in SGs (P<0.001). The majority of perforations were seen in the nondominant hand in surgeons and assistants hands, whereas scrub nurses had 85% of perforations in the dominant hand. The index finger was the site of perforations in DGs (53.4%; SGs, 43%). The inner gloves were breached only when the outer glove was found to be perforated. The duration of surgery had a direct impact on the number of perforations. There were no perforations in DGs in less than 60 minutes as compared with 3 (10.7%) in SGs. Between 60 and 120 minutes, the perforations in the DGs were 11, and in SGs, 21. During the study period, 4 patients had surgical site infection. Three were superficial and one deep-seated infection. In 3 patients with infection, the gloves were found to be perforated, and 1 patient with infection had no perforations in the gloves. CONCLUSION: Our study confirms that DGs are safer than SGs during pediatric orthopedic operations. In the event of nonavailability of DGs, SGs should be changed on an hourly basis during long procedures. Lastly, there exists a relationship between surgical site infection and glove perforations.

Equipment Design↗
PubMedDate not supplied

Osteoporosis among male Saudi Arabs: a pilot study.

BACKGROUND: Little attention has been paid to the problem of male osteoporosis in Saudi Arabia. In this prospective study we assessed the prevalence of male osteoporosis among Saudi Arabs. SUBJECTS AND METHODS: We studied Saudi Arabian males >50 years of age attending outpatient clinics at King Fahd Hospital of the University, Al-Khobar, between 1 May 2005 and 30 January 2006. We determined body mass index (BMI) and tests were done to rule out secondary osteoporosis. All subjects had a bone mineral density (BMD) measurement of the hip area and the lumbar spine using dual energy X-ray absorptiometry (DEXA). A T-score of < or = -2.5 SD that of young, healthy adults was taken as osteoporotic and scores between -1 to -2.5 SD were taken as osteopenic. RESULTS: One hundred fifteen patients (mean age, 61.8+/-0.75 years; range, 50 to 76 years) had a mean BMI of 24.7+/-0.35 (range, 18.5 to 31). Based on hip scans, the prevalence of osteoporosis was 24.3%. Sixty- four percent were osteopenic. Based on scans of the lumbar spine, the prevalence of osteoporosis was 37.4% and 33.9% were osteopenic. Spinal osteoporosis was more common than hip osteoporosis. CONCLUSIONS: Our study indicates that the prevalence of osteoporosis among Saudi Arabian males is higher than among Western males. More studies are needed to determine the national prevalence of male osteoporosis. It is recommended that serious measures to be undertaken to prevent male osteoporosis to stop any future epidemic of catastrophic osteoporosis-related fractures.

Absorptiometry, Photon↗
PubMedDate not supplied

Assessment of nosocomial urinary tract infections in orthopaedic patients: a prospective and comparative study using two different catheters.

Catheter-related nosocomial urinary tract infection in postoperative orthopedic and trauma patients was studied prospectively using nitrofuroxone-impregnated urinary catheters (study group) and regular silicone-coated Foley catheters. Fifty adults in each group were randomly assigned. In Group A, antibiotic-impregnated catheters were used, and in the other, non-antibiotic-impregnated urinary catheters were used (Group B). The variables studied were age, sex, type of surgery, duration of surgery, number of catheter days, days of intravenous line, and hospital days. In patients, urinary tract infection (UTI) was diagnosed by culture and the organism was isolated. The average age in the study group was 43.90 years (range, 14-95 years) compared with the control group (mean age, 42.22 years; range, 14-102 years). Catheter days in the nitrofuroxone-impregnated catheters was 7.9 days (range, 2-37 days) versus 7.2 days (range, 2-30 days). The intravenous line in the group was 9.16 days (range, 2-35 days) versus 8.8 days (2-22 days). There were six infections (P = 0.028) in the control group compared with the study group. The length of operation was similar in each group. Our study indicates that nitrofuroxone-impregnated catheters have the potential to reduce nosocomial catheter-related UTIs in postoperative orthopedic and trauma patients.

Adolescent↗
PubMedDate not supplied

Can double gloves improve surgeon-patient barrier efficiency?

The aim of this study was to compare double gloves (DGs) with single gloves (SGs) during orthopedic and trauma surgery in prevention of blood contact between patients and surgeons. DGs and SGs were collected after orthopedic operations, tested for size, site, and number of perforations. Medical records were reviewed for age, sex, type of operation, duration, and postoperative wound infection. Data were compared using t-test with level of statistical significance at P < 0.05. Five hundred seven operations yielded 1204 DGs and 830 pairs SGs. In DGs, perforations were detected in 220 outer glove and 39 inner glove (10.7%). In SGs, 226 perforations were detected (13.3%). The incidence of perforations in inner gloves of the double indicator glove was 1.6% (P < 0.001). During surgery, perforations were recognized in DGs in 67% compared with 12% in SGs (P < 0.005). This study confirms that DGs form an efficient barrier between patients and surgeons.

Equipment Failure↗