WatchPlus -:- IJMBS Table of Content(January - 2016)
IJMBS Table of Content: January 2016 4(1)

Research Articles

Ranhel C. De Roxas*, Ela A. Barcelon and Paul Matthew D.  pp. 01 - 04




According to the Monro-Kellie hypothesis, the sum volumes of the brain, cerebrospinal fluid and blood inside the cranium should always be maintained constant. Any abnormality that may increase the intracranial pressure might lead to fatal brain herniation. Hence, this paper aims to present a case of chronic subdural hematoma eventually developing a left hemispheric cardioembolic infarct and how it was managed conservatively without developing the dreaded complications of increased intracranial pressure. This is a case of a 62-year old female patient, diagnosed with severe Valvular Heart Disease, Diabetes Mellitus and Toxic Goiter, who developed Chronic Subdural Hematoma from regular warfarin intake. However, she later developed a cardioembolic stroke after holding warfarin. She was managed medically with decompression, since surgical evacuation was deemed of very high risk for this patient. In a patient with multiple comorbidities presenting with concomitant chronic subdural hematoma and cardioembolic stroke, conservative management with an osmotic diuretic and corticosteroids, though still with scarce evidence in the literature, was found to be safe and may be beneficial in our patient.

Keywords: Chronic subdural hematoma, warfarin use, cardioembolic stroke, conservative management.

Zeyad Al Hussain*, Abdullah Al Oboudi, Jamal Abdullah, Basil Mohammad, Nawfal Aljerian.  pp. 05 - 14




The Emergency Medical Services are an essential part of the health care system, directed toward saving lives by on scene care and transportation to health institutions. In Saudi Arabia 270 centers are situated all around the Kingdom as part of health care services. Since establishment there has not been enough research to assess quality of services.

1- Measuring satisfaction rate amongst recipients of emergency medical services.
2- The contrast between life threatening cases in terms of triage level and the services provided by emergency medical personnel.
3- Obstacles preventing proper evidence based practice by emergency medical services.

A cross sectional study was conducted using an instrument questionnaire consisting of 26 items. Interviews were made by telephone in the research unit at KAMC-Riyadh. 322 participants were included in the study. Females accounted for 37.3% while males were 62.7%. Cardiovascular related emergencies accounted for most cases 23.3%, followed by Trauma due to motor vehicle accidents 18.3%. Overall satisfaction was divided into six categories; Category C (good) was the highest accounting a total of 25.77% for both genders. Slow speed had highest percentage in scene arrival. Fast speed had highest percentage in hospital arrival. Data had been cross-tabulated with triage level. The ramification of Emergency Medical Services is a matter of life and death; henceforth, we strive for the Red Crescent to regain its impetus. KSA has been in the forefront of medical services with a notable less sumptuous growth in EMS sector. Training, communication, telecommunication technology and public education are good research areas to explore factors hindering Red Crescent services. The propensity of MVAs in 22 to 25 age group raises concerns regarding underlying issues. Trauma centers and rehabilitation services should be scattered equally considering high death rate of MVAs. Emergency roads should be re-established.

Keywords: Emergency Medical Services SA, Red Crescent SA, Red Crescent Saudi Arabia, Emergency Medical Services Saudi Arabia.