Mohammed Abdulaziz Almulhim
@imam abdulrahman bin faisal university
Assistant professor at emergency medicine department, College of medicine.
College of medicine.
RESEARCH, TEACHING, or OTHER INTERESTS
Emergency Medicine, Family Practice
Scopus Publications
Scopus Publications
Mohammed S. Alshahrani, Dunya Alfaraj, Jehan AlHumaid, Khalid Alshahrani, Aisha Alsubaie, Nasser Almulhim, Dana Althawadi, Salah Alam, Malak Alzahrani, Hassan Alwosibai,et al.
MDPI AG
Objective: The coronavirus disease (COVID-19) pandemic has disrupted healthcare systems worldwide, resulting in decreased and delayed hospital visits of patients with non-COVID-19-related acute emergencies. We evaluated the impact of the COVID-19 pandemic on the presentation and outcomes of patients with non-COVID-19-related medical and surgical emergencies. Method: All non-COVID-19-related patients hospitalized through emergency departments in three tertiary care hospitals in Saudi Arabia and Bahrain in June and July 2020 were enrolled and categorized into delayed and non-delayed groups (presentation ≥/=24 or <24 h after onset of symptom). Primary outcome was the prevalence and cause of delayed presentation; secondary outcomes included comparative 28-day clinical outcomes (i.e., 28-day mortality, intensive care unit (ICU) admission, invasive mechanical ventilation, and acute surgical interventions). Mean, median, and IQR were used to calculate the primary outcomes and inferential statistics including chi-square/Fisher exact test, t-test where appropriate were used for comparisons. Stepwise multivariate regression analysis was performed to identify the factors associated with delay in seeking medical attention. Results: In total, 24,129 patients visited emergency departments during the study period, compared to 48,734 patients in the year 2019. Of the 256 hospitalized patients with non-COVID-19-related diagnoses, 134 (52%) had delayed presentation. Fear of COVID-19 and curfew-related restrictions represented 46 (34%) and 25 (19%) of the reasons for delay. The 28-day mortality rates were significantly higher among delayed patients vs. non-delayed patients (n = 14, 10.4% vs. n = 3, 2.5%, OR: 4.628 (CI: 1.296–16.520), p = 0.038). Conclusion: More than half of hospitalized patients with non-COVID-19-related diagnoses had delayed presentation to the ED where mortality was found to be significantly higher in this group. Fear of COVID-19 and curfew restrictions were the main reasons for delaying hospital visit.
Mohammed A. Al-Mulhim, Mohammed S. Alshahrani, Laila Perlas Asonto, Ahmad Abdulhady, Talal M. Almutairi, Mariam Hajji, Mohammed A. Alrubaish, Khalid N. Almulhim, Mariam H. Al-Sulaiman, and Layla B. Al-Qahtani
SAGE Publications
Introduction Epinephrine is recommended for patients with out-of-hospital cardiac arrest (OHCA). However, whether epinephrine improves or adversely affects OHCA outcomes is controversial. Objectives This study aims to determine whether the frequency of epinephrine administration impacts OHCA patient survival. Methods We conducted a retrospective analysis of OHCA cases registered in the Emergency Department at King Fahd University Hospital, Saudi Arabia between 2005 and 2015. The primary outcomes were mortality and survival rates until discharge. The impact of epinephrine administration timing and frequency on patient survival was analyzed. Results Data from 300 OHCA cases were analyzed. Among them, 66.3% were men, and the overall mean age of 50.4 ± 20.6 years. The overall survival rate until hospital discharge was 12%. There was no statistically significant difference between in gender, age, or time interval to the first epinephrine dose in the survival and non-survival groups. Only the number of epinephrine doses was related to the survival outcome. Conclusion Non-survivors received significantly more epinephrine doses compared with survivors. However, a causal relationship between OHCA patient survival and epinephrine dose and time cannot be confirmed. Further studies are needed to investigate whether the long-term outcomes in OHCA patients are influenced by the timing and frequency of epinephrine administration.
Mohammed Alshahrani, Bander Dhafery, Mohammed Almulhim, Noor Bukhamsin, Faisal Alkhadra, and Doaa Albagshi
Informa UK Limited
Background This study explores the most influential factors affecting Saudi medical students and interns’ choice of specialty at the University of Dammam, Kingdom of Saudi Arabia. Methods A self-administered questionnaire was distributed during the period from June 1 to June 14, 2013. Chi-square test and logistic regression were used to test the association between participants’ choices and the motivational factors that led to their choice of specialty. Results One-hundred sixty-eight (44.7%) participants chose lifestyle as their most influential factor for the choice of their specialty. Significantly more medical interns considered lifestyle as an important factor compared to medical students (P=0.020). Internal medicine was the preferred specialty for 56 participants (14.77%) followed by family medicine for 35 participants (9.2%). Thirty-four participants (8.97%) chose general surgery, and 27 participants (7.1%) chose both pediatrics and emergency medicine. Sex influences indicated that men preferred pediatrics and emergency medicine (P=0.033 and P=0.0006, respectively), while women preferred family medicine practice (P=0.034). Conclusion Saudi medical students and interns at the University of Dammam were influenced mostly by lifestyle when they considered their future specialty. Internal medicine, family medicine, general surgery, pediatrics, and emergency medicine were the preferred specialties.
M Alhelail, M Al-Salamah, M Al-Mulhim, and S Al-Hamid
BMJ
Objective: This study compared the efficacy in terms of pain of injection, time of onset and duration of action of digital blocks of bupivacaine 0.5% alone and lidocaine 1% with epinephrine (1:100 000). Methods: A randomised double-blind prospective study was performed in a single self-controlled group of 12 healthy volunteers (4 women, 8 men). Each participant was randomised to receive either lidocaine 1% with epinephrine (1:100 000) or bupivacaine 0.5% in either the right or left middle finger. Pain of injection was measured as the primary outcome using a 0–100 mm visual analogue scale. The time before anaesthesia to pinpricks was recorded and the duration of anaesthesia was reported by all volunteers. Statistical analysis was conducted using the non-parametric Wilcoxon signed rank test. Results: Median visual analogue scale scores were significantly different between the lidocaine + epinephrine and bupivacaine groups (26.00 mm (4–52) vs 40.50 mm (10–71), p<0.05). The median time before anaesthesia to pinpricks was not significantly different between the two drugs (3.45 min (3–8) vs 3.30 min (3–8), p = 0.84). The median time needed for return of pinpricks was significantly different between the two drugs (321 min (228–463) vs 701 min (245–913), p<0.05). Follow-up was completed at 24 h. Conclusion: Lidocaine (1%) with epinephrine (1:100 000) was significantly less painful and had a shorter duration of action than bupivacaine (0.5%), which had a similar onset of action for digital nerve block. Trial registration number: ISRCTN45121950