Sports injuries in Saudi Arabia.

Saudi Arabia has now a wealth of sporting facilities of which the youth of the country is making full use. A prospective study of sports related injuries was conducted during the twelve months of 1983. We present an analysis of 846 such injuries seen at the King Fahd University Hospital, Al Khobar. These injuries formed 8.36% of those who attended after an accident for emergency treatment, of which 63% were under 20 years. The majority was sustained during soccer games. The most frequent site of injury was the knee. We believe that specialised Sports Injury Clinics, initially based at the University Hospitals should be established here, to give guidance and education concerning avoidance of injuries, and for the treatment and follow-up of those injured and enable them to return to sports early.     

Soccer injuries in Iceland

We investigated the frequency, cause and location of injuries in Icelandic elite soccer in 1991. The incidence of injuries for the individual player was 34.8 ± 5.7 per 1000 game-hours and 5.9 ± 1.1 per 1000 practice-hours. The most common types of injuries were muscle strains (29%), ligament sprains (22%), contusions (20%), and other injuries (29%). The frequency of reinjury was markedly high, where 44% of the strains and 58% of the sprains were registered as reinjuries. Strains occurred mainly during sprinting, sprains by tackling, and contusion during other contact. Significantly more injuries occurred on artificial turf than on grass or gravel in correlation to number of hours in games and practices. Teams who had the longest pre-season preparation period obtained significantly fewer injuries during the season.     

Soccer injuries in childhood

A prospective study of soccer injuries, involving 287 male youth players, from the ages of 12-15 was conducted in 24 Greek soccer clubs, during the course of one year. A total of 193 players sustained 209 injuries. The incidence of injuries was 4.0 injuries per 1000 h of soccer time per player, and the most common types of injuries were sprains and strains. Surprisingly, it was found that an increase of injury incidences occurred during practice. Fifty-eight injuries required medical assistance. The majority of injuries (80%) were located in the lower extremities. Collision with other players was the most common activity at the time of injury, accounting for 40% of all injuries. The conclusion of this study and the evidence from other studies suggests that youth soccer is a relatively low risk sport. However, a substantial amount of injuries could be prevented. It is necessary to identify the risk factors, which are associated with these types of injuries.     

Soccer injuries among youth

This study reports the quantitative and qualitative aspects of sports injuries in a 5-day youth soccer tournament with 12,907 players. A total of 132 injuries that resulted in at least one days' absence from soccer playing were of special interest. The overall injury rate was 3.6 for boys and 4.4 injuries per 1000 hours of play for girls. Statistically significantly higher injury rates between players in puberty and differences in type and location of injuries between boys and girls were found. In 77% of the cases, the injury happened while the injured player was in physical contact with another player, 59% had ball contact and 7% had no contact with any person or ball at all. Five months later a questionnaire was send out to the serious injured players. Of 85 injured players, 10 were absent from school or work on average 11.5 days. Five had surgery. Injury prophylaxis in soccer tournaments is proposed.     

Self-reported needlestick injuries in dental health care workers at Armed Forces Hospital Riyadh, Saudi Arabia

The objective of the present study was to assess the incidence of sharps/needlestick injuries among dental health care workers (DHCWs) at Armed Forces Hospital Riyadh. A questionnaire was distributed among all dental staff, including dentists, hygienists, and dental surgery assistants. Results show that 65 individuals (58%) had sharps/needlestick injuries, and of these, more than half did not report these injuries to the appropriate department. At the time of injury, the majority of the DHCWs were vaccinated or immune, but a few of them were not vaccinated against hepatitis B virus. This study concludes that every DHCW should be immunized against hepatitis B virus to avoid cross-infection from sharps/needlestick injuries, which are quite common in a dental practice. The high frequency of these injuries could be reduced by simple interventions.     

Firearm fatalities in Dammam, Saudi Arabia

This paper provides a database representing injury mortality in Dammam, Saudi Arabia, with the aim of establishing a system which will record information about the incidence of such deaths, identify new trends and give priority to violence prevention. The retrospective study was carried out on 64 fatalities from gunfire injuries at the Forensic Medicine Centre in Dammam, Saudi Arabia during the period from January 2002 - December 2006. The deaths included 55 cases of homicide, seven cases of suicide and two accidental shootings. Twenty-six victims were aged between 16-30 years and 24 victims were between 31-45 years. Fifty-nine of the cases were male. A handgun was the weapon used in 49 cases. The most common sites for the firearm entrance wounds were the head (45 cases) and the chest (35 cases). In the majority of cases (56.3%) a single shot was fired while in 15.6% of cases there were two shots. In 51.5% of cases no bullet was recovered from the body while a single bullet was recovered in 31.5% and two bullets in 6.2% of the cases. Distant range fire was observed in 65.6% of cases. Exit wounds were found on the head in 36.7% and on the chest in 28.7% of cases. The majority of victims were young males living in urban areas. This result should help in forming a strategy to improve the livelihoods of this group. The low incidence of alcohol abuse (one case, 1.56%) and only three cases (4.68%) of amphetamine abuse is significant.     

Soccer injuries of youth.

During a soccer tournament with participation of 6,600 boys and girls (9-19 years) all injuries were evaluated, 5.2% of the players were injured; out of these 51% had "slight injuries", 42% "moderate injuries" and 7% "severe injuries". For the individual player the incidence of injury was 19.1/1,000 playing hours including all degrees of injuries; if "slight injuries" were excluded the incidence was 9.4/1,000 playing hours. The incidence rose with increasing age, girls were injured more often than boys. There were 81% of all injuries localised to the lower extremity, especially the ankle and foot. Contusion was the most frequent diagnosis, amounting to a third of all injuries. Blisters and exoriations amounted to nearly a fifth, 4% of the injuries were fractures, especially in the upper extremity; overuse injuries were seen only in 5.2% of the cases. Based on examination of the injury pattern in these children, injuries of youth seem to be relatively rare and mostly of a non-severe character.     

Soccer injuries among elite female players

Injuries occurring in two female elite soccer teams were recorded during 1 year. Of 41 players, 33 (80%) sustained 78 injuries. The incidence of injury during games was 24/1000 hours, while the incidence during training was 7/1000 hours. The majority (88%) of injuries were localized to the lower extremities, with equal occurrence in the left and right legs. Forty-nine percent of the injuries occurred in the knee or ankle. Most of the injuries were minor (49%), while 36% were moderate and 15% were major. Of the major injuries (N = 12), 10 were due to trauma and 7 (58%) were knee ligament or meniscal tears. Overuse injuries constituted 28% of all injuries and occurred mainly during preseason training and at the beginning and end of the competitive season. Traumatic injuries (72%) occurred mainly during games with a predominance at the beginning of the competitive season. Almost 80% of the traumatic injuries occurred during physical contact with an opponent. Extrinsic factors such as weather, playing surface, temperature, or the position of the player within the team did not influence the injury rate. We conclude that female elite soccer players sustain a high incidence of injury. Few injuries were major, but 17% of the players sustained a major knee injury during the year.     

Feasibility of using ultrasound in ambulances in Saudi Arabia

BACKGROUNDIn developed countries, the economic feasibility of using ultrasound in ambulances before arriving at the hospital has been achieved through comprehensive studies, and this of course does not apply to Arab countries, as there are no current studies to support this. Therefore, this study is a preliminary measure of the economic feasibility of using ultrasound in ambulances in Saudi Arabia.AIMTo measure the demand for ultrasound equipment in ambulances in Saudi Arabia.METHODSA cross-sectional study of five different groups of participants including radiation technologists, emergency physicians, paramedics, Red Crescent managers and the public. Email and social media were used to deliver a questionnaire to these groups. The questionnaire included specific questions to measure the purpose of ultrasound use in each group of participants.RESULTSEach group had some knowledge on ultrasound and its benefits. More than 50% in each study group supported the availability of ultrasound in ambulances. Additionally, 60% of emergency physicians reported that they had difficulties in venous access, checking the presence of internal bleeding, recognizing pregnancy in trauma cases, and inserting endotracheal tubes, and the majority of them confirmed the effective role of ultrasound in achieving such tasks. Almost all paramedics (93.33%), physicians (98.89%), and Saudi Red Crescent managers (96.3%) emphasized the importance of communication between ambulance staff and emergency departments. Moreover, most physicians (77.78%), and technologists (82.73%) supported the presence of paramedics in ambulances to operate ultrasound in order to improve patient outcomes.CONCLUSIONMost of the study groups evaluated had knowledge on ultrasound and supported the presence of ultrasound devices in ambulances.     

Hanging deaths in Dammam,Kingdom of Saudi Arabia

A retrospective study was carried out on 133 suicidal hanging cases autopsied at Forensic Medicine Center in Dammam, Kingdom of Saudi Arabia (from 2003 to 2007). Of these cases, 115 (86.46%) were males and 18 females (13.54%), with an average male:female ratio of 6.38. There was an increasing trend of hanging among ages between 21 and 50 years (88.7%), and the fourth decade had the highest number of victims (about 36%) between all age groups.Local Saudi nationals comprised a small proportion of cases (21 persons, 15.8%), while the others were foreigners working in the Kingdom with an Indian precedence (63 persons, 47.4%), followed by other 11 different nationalities representing 36.8% of the cases. The peak of these suicidal acts was in June and the least was in February and December. Postmortem blood alcohol was found in 6.76% of cases, amphetamine in 3% (4 cases), and cannabinoids in 2.25% (3 cases). About 75% of the deceased persons were male laborers (100 cases), 11.27% were female housemaids (15 cases), and only 13 persons were unemployed (9.77%). Previous history of psychological illnesses was documented in 19 cases (14.28%) and stressful family problems in 6% of cases. There were previous suicidal attempts in only one case. Suicidal note was found in only seven cases.In conclusion, there was a decreasing trend of suicide by hanging in Dammam from 39 cases in 2003 to 17 cases in 2007, with a rate of 0.85/100,000 population in the last year. This was inconsistent with the overall increase in suicide rate in Dammam when compared to the previous decade.     

Factors affecting reporting of suspected child maltreatment in Saudi Arabia

Child maltreatment is a global issue. Child maltreatment can take many forms including neglect, physical abuse, emotional abuse, and sexual abuse. The aim of this review is to determine different factors that influence the lack of reporting of child maltreatment in Saudi Arabia. This paper classified these factors into barriers related to the cultural impact, healthcare practitioners, the abused children, and policy making. The cultural influence was manifested in the stigma around reporting due to lack of understanding of what child abuse is, perceiving it as a parental right to discipline a child, misunderstanding the Islamic laws, and diminished understanding of the long- and short-term consequences of child abuse. Healthcare professionals and students of healthcare specialties revealed not reporting suspected child maltreatment due to uncertainty of the occurrence of abuse, lack of knowledge on the matter, considering injuries to be unworthy of reporting, unawareness of protocols, prior negative experience after reporting, and the absence of strict legal consequences of not reporting. Abused children were found to rarely report maltreatment to authorities due to a variety of reasons such as lack of confidence, fear of breaking up their family, or being unaware of the occurrence of maltreatment in the first place. Saudi Arabia's public regulations do not specify when a physician should be concerned about improper conduct regarding child maltreatment. It is recommended that Saudi Arabia organizes child maltreatment awareness campaigns, intensifies the training of healthcare professionals, and sets precise mandatory reporting legislations. Child maltreatment is a problem that affects the society as a unit. Therefore, it mandates the collaboration of the whole community to eliminate this medico-social issue.     

Pediatric poisoning deaths in Saudi Arabia: A systematic review

Poisons are potentially harmful substances that can cause damage to the human body. Children are a vulnerable group to poisoning. This article aims to review the deaths due to poisoning among children in Saudi Arabia. A comprehensive search was conducted on 13 January 2022 using PubMed, Scopus, and Web of Science databases to identify articles that reported on pediatric poisoning deaths in Saudi Arabia. Eight articles met the inclusion criteria and were included in this systematic review. Some articles included one city, for instance, Jeddah or Riyadh, while others included different regions of the country. Children got poisoned most commonly at their homes by accidental ingestion. The common substances that caused fatality included drugs and pesticides. Low caregiver awareness and neglect were recognized as risk factors for pediatric poisoning. Further studies should be conducted to provide comprehensive details about the victims, the poisons involved, and the circumstances of pediatric poisonings in Saudi Arabia at the national and sub-national levels. Public awareness campaigns should be organized to raise community awareness about safety measures and risks of neglect to prevent pediatric poisonings.     

Soccer injuries and their mechanisms: a prospective study

In order to study the incidence and mechanisms of injury in soccer and to recommend prophylactic measures, 180 players in a senior male soccer division were followed prospectively for 1 yr. Attendance records for games and practice sessions were kept, and all injuries were examined and treated by the same orthopaedic surgeon. One hundred twenty-four players incurred 256 injuries, mostly sprains and strains of the lower extremities. Of these, 62% were considered minor with ankle sprains being the most common (17%), while 11% were considered major with knee ligament sprains being the most frequent (32%). Overuse injuries were most frequent in the preseason training period. Traumatic leg injuries involved players with inadequate or no shin guards. Of the traumatic knee injuries, 11 of 18 (61%) occurred during a collision; non-contact knee injuries were frequently seen in those players with a history of knee injury and existing instability. Study of injury sequence disclosed that a minor injury was often followed within two months by a major one. In addition, with severe injuries incurred during fouls, the individual causing the penalty was injured. This prospective study suggested that those with knee instability and those allowed to resume play with poorly rehabilitated or clinically unhealed injuries are more apt to sustain further injury. Some injuries can be avoided by using better equipment and by observance of the rules.     

Soccer injuries: a review on incidence and prevention

Several investigators have studied the incidence and causes of soccer injuries in male professional players; however, epidemiological data on injuries in female soccer players are limited. From the data presented, it can be estimated that, on average, every elite male soccer player incurs approximately one performance-limiting injury each year. Nine studies on the prevention of soccer injuries were found in the literature. There is some evidence that multi-modal intervention programmes result in a general reduction in injuries. Ankle sprains can be prevented by external ankle supports and proprioceptive/coordination training, especially in athletes with previous ankle sprains. With regard to severe knee injuries, the results of prevention studies are partly inconclusive; however, training of neuromuscular and proprioceptive performance as well as improvement of jumping and landing technique seem to decrease the incidence of anterior cruciate ligament injuries in female athletes. Prevention programmes are likely to be more effective in groups with an increased risk of injury. More methodologically well-designed studies are required to evaluate the effects of specific preventive interventions.     

Obstetric and gynecologic malpractice claims in Saudi Arabia: Incidence and cause

IntroductionThe occurrence of a bad outcome, injury or death of a patient during treatment increases the chance of malpractice litigation, increases legal responsibility and leads to increased fees for malpractice insurance. Physicians practicing obstetrics and gynecology face among the highest risks of malpractice litigation, and such litigation has led to an increase in the practice of defensive medicine and has made this specialty less appealing. Previous clinical data from Saudi Arabia have shown that more malpractice litigation concerns claims in obstetrics and gynecology than claims in any other field of medicine.ObjectiveTo identify the main causes of obstetrics and gynecology (OBGYN) professional liability claims in Saudi Arabia to have a better understanding and management of risks.MethodsAll OBGYN claims opened in Saudi Arabia between 2008 and 2013 were analyzed to identify the most common causes of claims. The results of these claims and the times until a final judgment made were also analyzed.ResultsOut of a total of 463 malpractice claims that were closed during the study period, 114 (24.6%) claims were in obstetrics and gynecology, and 92 (80.7%) of these claims concerned complications related to delivery room events. The most common causes of obstetric malpractice litigation were shoulder dystocia (brachial plexus injury) and fetal distress (hypoxic ischemic encephalopathy). Urinary system injury was the most common cause of gynecology cases. Most cases were decided in favor of the defendants with the exception of cases for which maternal and/or fetal death was the cause of litigation; nearly all of those cases were decided against the defendants.ConclusionObstetricians face a high risk of malpractice claims in Saudi Arabia, although most claims do not end in payments to plaintiffs. However, the effects of such claims on obstetric care should not be underestimated. Adherence to standards of care and careful documentation may decrease litigation and the number of indefensible malpractice claims.     

Pattern of viral hepatitis infection in a selected population from Saudi Arabia

Viral hepatitis is an important health problem worldwide. Globally, three major viruses are the leading cause of hepatitis: hepatitis A, B, and C. In this study, we have investigated the pattern of hepatitis among the National Guard personnel and their extended families seen in the central region of Saudi Arabia. The most dominant type of hepatitis infection was hepatitis B virus (HBV), followed by hepatitis C virus (HCV), and to a lesser extent hepatitis A virus (HAV). Our results showed three different age groups at risk of acquiring the infection: HAV, which is mainly a disease of the young; HBV, a disease of adolescents and adults; and HCV, a disease of the elderly. There was no significant difference in the male:female ratio in HAV and HCV; however, as seen in the developed countries, more males were affected with HBV than females. These data will pave the way for further studies by identifying the risk groups for the three major hepatitis infections and by using the data as a preventive tool to educate those risk groups.