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Introduction: Palliative care is a multidisciplinary approach that aims to improve the quality of life of patients with life-threatening illnesses. It has been recognized as a crucial part of patient care in oncology. Palliative care service was established in the comprehensive cancer center of King Fahad Medical City (KFMC), Riyadh, Saudi Arabia in March 2010. The objective of this study was to determine the interval between the first palliative care consult (PCC1) and death, and explore the possible cause of suggestive short timeframe between PCC1 and death. Patients and Methods: This study included 210 cancer patients who had their PCC1 in KFMC within the period of March 2012 and March 2014. Demographic information, cancer diagnosis, date of cancer diagnosis, reason for referral, all symptoms reported in Palliative Care Unit, and date of death were gathered from the patients' charts. The interval between the PCC1 and death were computed and analyzed. Results: Of the 210 patients, 121 (57.6%) were female, 127 (60.5%) were <60 years old, and 190 (90.5%) had non-haematological tumours. The main reasons for referral were symptom control (62.4%), symptom control and end of life (EOL) care (12.4%), symptom control and transfer of care (11.4%), and EOL care (8.6%). The median interval between PCC1 and death, diagnosis to PCC1, and diagnosis to death intervals were 19, 212, and 360 days, respectively. Patients diagnosed with haematological tumours were referred relatively earlier to palliative care. The difference in the mean (haematology > non-haematology) for the interval between PCC1 and death was 146.2 days (P < 0.001). Conclusions: Late referrals to palliative care services KFMC is the strongest predictor of the short interval between PCC1 to death of advanced stage cancer patients. Identifying the potential cause of the late referrals can lead to developing optimal policies for the timely referral of cancer patients to palliative care upon diagnosis regardless of the stage of their disease. Education and advocacy are needed among the referring oncologists in the cancer center for earlier access to palliative care. Future studies are needed to establish the appropriate timing of the PCC1.

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This review is intended to summarize the literature in regard to blood donor-related platelet defects that might affect the quality of platelet concentrates (PCs). Donor-related platelet defects can be defined as all platelet defects, transient or permanent in nature, which may undermine the effectiveness of platelet therapy that are caused by factors related to the donor, and not due to collection, processing or storage. Although it seems that those factors might affect the quality of PCs, there is still significant work that needs to be done to understand their impact on the efficacy of platelet transfusion.

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Objectives: To determine the importance of minor surgical procedures that could be done by physicians or general practitioners at Primary Healthcare Centers (PHCC) and to determine the important and major obstacles for physicians' inability to perform minor surgeries (MS) at PHCC. Methodology: Data was collected through a self-administered questionnaire distributed to all primary healthcare physicians in 26 PHCC in Al-Qatif by the official mail of Al-Qatif PHCC Administration. Data was also collected by filling a checklist by the researcher. The data was analyzed using Statistical Package for Social Science. Results: A total of 61, out of 70 physicians working in Al-Qatif PHCC, completed the self-administered questionnaire which yielded an overall response rate of 87%. 42 (68.6%) participants found themselves as competent to practice MS, and 19 (31.2%) found themselves as not competent to practice MS at PHCC. The highest mean for the degree of importance and confidence, when comparing both, was the insertion of sutures with a statistically significant P value (0.000). Coded surgical referral in all Al-Qatif PHCC over 1-year was 6,187 (25.4%) out of 24,369. Conclusion: Most of the physicians in Al-Qatif PHCC are interested and feel competent in performing MS and they encourage establishing MS program in the PHCC. However, majority of the physicians in Al-Qatif PHCC are not confident in practicing most of the procedures listed in the survey, although they believe that these procedures are important in their practice.

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