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Introduction: The implementation of triage systems seeks to aid patient organisation in order to assure smooth patient flow. Inconsistency in the application of the triage system at a local university hospital has been a recent concern for the administrative faculty. Therefore, our aim was to validate the implementation of the Canadian Triage and Acuity Scale (CTAS), currently applied by nurses, in a university hospital. Materials and Methods: Patient information was collected in the Emergency Department and translated from real case scenarios into paper-based scenarios. A total of 49 cases were distributed among 45 nurses to categorise. The nurses' categorisations were compared with a CTAS expert's categorisations. Results: Of the 2,205 cases (49 cases each given to the 45 nurses), 49% (1,059 cases) were correctly categorised and 51% (1,146 cases) were miscategorised. Overtriage and undertriage percentages were 55.93% and 44.07%, respectively. The highest level of agreement between nurses and the expert categorisation was in category 1; the lowest was in category 5. Conclusion: The nurses' overall results were below expectations. Statistically significant variables affecting correct categorisation included age, experience, education level and nationality of the nurses. Nurses above the age of 45 years with more years of experience, obtained top scores. Nurses with the highest level of education also scored significantly higher. Filipino nurses scored better than nurses of other nationalities. With the widespread utilisation of triage systems in the region, further studies that evaluate their implementation are needed.

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Background and Objectives: In Saudi Arabia, most drugs can be obtained from pharmacies without a professional prescription, and despite the prevalence of self-medication, few comprehensive studies were conducted to assess this practice. This study was performed to evaluate self-medication and its pattern among different groups of King Saud University students. Materials and Methods: A quantitative cross-sectional study was carried out from November 2014 to April 2015. The targeted population of the study was 477 out of 35,810 undergraduate medical and non-medical students at King Saud University. Data were analysed using SPSS (21.0), and descriptive statistics was used to describe the categorical study and outcome variables. Chi-square test was used to compare the distribution of proportions. Results: The prevalence of self-medication within the study period was 50.9% of the respondents (45.18% male and 54.02% female). Cold and flu symptoms were the most common indication among medical (74%) and non-medical students (88.2%). Bacterial and viral infections (P = 0.001) were a common indication among the medical students (19.4%). Analgesics (P = 0.333) was the most common drug used in self-medication among medical (89.7%) and non-medical students (85.3%). Aspirin (P = 0.013) and herbals (P = 0.0001) were reported to be predominantly used by the non-medical students. Conclusion: Half of the respondents practice self-medication; which demonstrates the need to raise public awareness, becoming more conscious during drug utilisation and the pharmacists' advisory role. In addition, further studies should be conducted to assess the herbals' practice in our community as their use was reported to be high in the results.

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Over the past decade, the world has radically changed. New advances in information and communication technologies (ICT) connect the world in ways never imagined. Public health informatics (PHI) leveraged for public health surveillance (PHS), can enable, enhance, and empower essential PHS functions (i.e., detection, reporting, confirmation, analyses, feedback, response). However, the tail doesn't wag the dog; as such, ICT cannot (should not) drive public health surveillance strengthening. Rather, ICT can serve PHS to more effectively empower core functions. In this review, we explore promising ICT trends for prevention, detection, and response, laboratory reporting, push notification, analytics, predictive surveillance, and using new data sources, while recognizing that it is the people, politics, and policies that most challenge progress for implementation of solutions.

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Sri Lanka was declared malaria-free on 5 September 2016 by the World Health Organization. This success was the result of over a century of efforts that combined disease surveillance, vector control and treatment. By 2008, there was zero mortality from indigenous cases, and the country witnessed its last indigenous case in 2012. This process involved long-term, sustained financial support, particularly from the Sri Lankan Government, the World Bank and the Global Fund. Given that malaria is still a global health burden, there is much to be learnt from Sri Lanka's achievement in the ongoing efforts to reach a malaria-free world.

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Background: Breaking bad news to patients with cancer diagnosis is not an easy task for physicians. The diagnosis must be explicitly stated and understood, and prognosis must be well-discussed in the most gentle and comfortable manner. It is important that the disclosure is performed in a way that patients will not lose all hope and get very depressed, leading them to undergo an abrupt change of their outlook in life. Objective: The aim of this study was to explore the physicians' perceptions and perspectives of breaking bad news to cancer patients. Methods: A cross-sectional survey of all comprehensive cancer centre physicians currently working in a university teaching hospital in the Middle East was conducted from August to September 2016. Results: Sixty-eight percent responded to the survey. Eighty-four percent were comfortable with breaking bad news, and 70% had training in breaking bad news. Eighty-six percent of responders stated that patients should be told about their cancer. Almost 30% of the respondents stated that they would still disclose the diagnosis to patients even if it would be against the preference of the relatives. Nearly 61% said that they would only tell the details to the patients if asked while 67% of them disagreed that patients should be told about the diagnoses only if the relatives consent. About 51% of physicians wanted to discuss the bad news with the family members and patient together, whereas 24% stated that the patient alone should be involved in the discussion. Conclusion: Physicians face a dilemma when families do not wish the patient to know the cancer diagnosis and this highlights the necessity of taking into consideration the social circumstances in healthcare. When taking these into considerations, curriculum in the medical school must, therefore, be updated and must integrate the acquisition of skills in breaking bad news early in training.

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Background: Medical laboratory technologists (MLTs) are required to gain credit for continuous professional development for relicensing as well as for their own career-long learning. International studies have shown that MLTs who undertake continuing medical education (CME) have improved productivity, enhanced professional flexibility and high work fulfilment. The time spent on CME is associated with professional competency. Previous national research has shown that attendance at CME programmes in Saudi Arabia is likely affected by demographic factors. The objective of this study was to explore the perceptions of MLTs towards CME activities and to predict factors that affect attendance. Methods: A self-administered questionnaire was given to 103 medical laboratory professionals from the Security Forces Hospital as part of a cross-sectional descriptive study. Data were analysed using SPSS version 21. Results: The overall mean score was 3.88 for the 103 questionnaires, indicating an affirmative perception of the CME programmes. Males in the age group 25-34 years accounted for 61.2% of responses. The preferred delivery modes for CME programmes were short courses and workshops (23%) and higher education relevant courses (20%). For those who had attended CME and those who had not, no significant difference was found in gender, age, field of specialty, education categories or working experience. Conclusion: Most laboratory technicians in our study reported favourable perceptions of CME programmes, feeling that they increased professional confidence and competency. We recommend that core competencies be integrated into credentialing using profession-specific CME in a workplace setting. In addition, MLTs should be involved in designing the programmes as well. Further studies in a multicentre institution are needed to analyse the difference in perception among those who have attended CME and those who have not.

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Context: Determining the efficacy of any surgical treatment is the key to achieve better practice and best outcomes for patients. Aims: This study is designed to address midterm outcome in adult patients with moderate-to-severe hallux valgus (HV), who underwent scarf osteotomy from 2012 to 2014. Settings and Design: This is a retrospective cohort study in which charts of all adult patients with moderate-to-severe HV who underwent scarf osteotomy from 2011 to 2014 were reviewed. Subjects and Methods: Between 2011 and 2014, 39 patients (41 feet) who underwent scarf osteotomy for correction of HV deformity were retrospectively evaluated. Standard weight-bearing dorsoplantar radiographs were obtained pre- and postoperatively. HV angle (HVA), intermetatarsal angle (IMA) and distal metatarsal articular angles (DMAA) were measured pre- and postoperatively to evaluate the efficacy of the surgery. The complication rate was reported. The average follow-up was 13.5 months, and the patients' mean age was 37 years. Statistical Analysis Used: Data were compared using Chi-square test or Fisher's exact test whichever was appropriate. All tests were two-sided, and a P> 0.01 was considered statistically significant. Results: The average preoperative HVA and IMA were 32° and 14.3°, which improved to 11° and 7.9°, respectively. The changes were statistically significant (P < 0.01). The average DMAA was 16° which was reduced to (12°); however, the change was not statistically significant (P > 0.18). Conclusions: This study suggests that scarf osteotomy surgery is a very versatile osteotomy in correcting moderate-to-severe HV deformity. It offers a greater degree of correction and stability, lower rate of complications and good outcome. However, long-term follow-up studies are still needed.

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Context: Developmental dysplasia of the hip (DDH) is a spectrum of disorders ranging from subluxation to complete dislocation of the hip joint. There are limited number of recent studies describing the characteristics of patients with DDH in Saudi Arabia. Aims: The aim of the study was to describe the characteristics of DDH patients and the types of treatment methods they underwent. Subjects and Methods: The present retrospective study comprised data exploring some related factors of DDH in King Abdulaziz Medical City (KAMC) in Riyadh from 2004 to 2014. Primary data of children referred to the orthopaedic outpatient clinic with DDH were analysed. Data included: gender, laterality, place of delivery, age at the time of diagnosis and type of intervention. Descriptive and inferential statistics were computed. Results: A total of 176 DDH diagnosed patients were studied; 151 of which were female (85.8%). Of whom, 87 patients were delivered at KAMC (49.4%). There were 82 patients diagnosed with bilateral DDH (46.6%). The ages of diagnosis were included with 88.8% of the sample diagnosed after 3 months which was highly associated with unilateral disease (P < 0.001). There was a highly significant difference between the place of delivery and the age of diagnosis (P < 0.001). Pelvic osteotomy was the intervention in 50% of the cases. There was a statistically significant difference in the type of intervention with laterality (P = 0.016), age of diagnosis (P < 0.001) and place of delivery (P = 0.015). Conclusions: The awareness of DDH should be increased among paediatricians to decrease the incidence of late DDH diagnosis. A structured screening program has to be created and implemented in all hospitals of the country to detect DDH earlier and to provide treatment as early as possible.

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