The Awareness of Child Abuse and Neglect Among the Saudi Population: A Narrative Review.

Child abuse and neglect (CAN) is a pressing global issue with profound implications for the well-being of children. The aim of this review is to examine the existing literature and synthesize evidence on the awareness, knowledge, and attitudes toward child abuse and neglect within the Saudi population. This review synthesizes the existing literature to illuminate the awareness, knowledge, and attitudes surrounding CAN within the Saudi population. Ten studies spanning the years 2019-2023 were meticulously analyzed, offering a comprehensive snapshot of CAN perceptions across various segments of society. The studies, encompassing diverse methodologies and populations, collectively underscore the commendable levels of awareness and knowledge demonstrated by healthcare professionals, including primary healthcare (PHC) physicians, nurses, and medical practitioners. Notably, several studies reveal that these professionals exhibit robust recognition of different forms of child abuse, a vital aspect in the identification and prevention of abuse cases. While positive attitudes toward CAN were prevalent among healthcare providers, barriers to reporting were highlighted. The fear of consequences and uncertainty emerged as key deterrents to reporting among medical and dental students and nurses, respectively. These findings emphasize the necessity for creating supportive environments that empower professionals to report suspected cases of abuse while addressing apprehensions. The parental perception of CAN also came into focus, revealing a disparity between the recognition of CAN as a common problem and the adequate knowledge of emotional abuse and neglect. These findings point toward a need for targeted public awareness campaigns that differentiate between disciplinary practices and abusive behaviors. In conclusion, this review offers a nuanced understanding of the Saudi population's awareness, knowledge, and attitudes toward child abuse and neglect. The synthesis of findings across diverse studies informs future interventions, advocating for enhanced awareness, reporting, and prevention strategies. By empowering individuals and professionals alike, a safer environment for Saudi children can be nurtured, fostering a future free from the shadows of abuse and neglect.

Single-Anastomosis Sleeve Jejunal Bypass as a Treatment for Morbid Obesity: A Systematic Review and Meta-Analysis.

Single-anastomosis sleeve jejunal (SASJ) bypass is a bariatric surgery technique with promising results. However, evidence of its efficacy and safety is still lacking. This study aimed to summarize the evidence regarding the efficacy and safety of SASJ bypass surgery in the treatment of morbid obesity. The literature was searched for English-language studies published from inception till November 26, 2023, on MEDLINE/PubMed, Cochrane Library, Web of Science, ProQuest, Scopus, SCINAPSE, and Google Scholar. The search terms included "morbid obesity," "bariatric surgery," and "single anastomosis sleeve jejunal bypass." Extracted data included the body mass index (BMI) before and after surgery, percent total weight loss (%TWL), percent excess weight loss (%EWL), and improvement in preoperative comorbidities. Pooling of the data was done using random effects or fixed-effect models based on the presence of significant heterogeneity. Nine studies were included in this systematic review and meta-analysis. The change in BMI from baseline at 12 months after SASJ bypass was significant (standardized mean difference (SMD) = -3.576, 95% confidence interval (CI) = -5.423, -1.730; I² = 99.23%). At 12 months after surgery, the pooled %TWL was 42.526 (95% CI = 37.948, 47.105; I² = 97.15%), and the pooled %EWL was 75.258 (95% CI = 67.061, 83.456; I² = 99.26%). The pooled incidence of postoperative improvement in diabetes mellitus was 91% (95% CI = 79.6%, 98%, I² = 82%). The overall rate of complications was 9.9% (95% CI = 2.5%, 21.6%; I² = 92.64%). Regarding the short- and mid-term outcomes, SASJ bypass is a safe and effective procedure for weight loss in patients with morbid obesity, with an acceptable rate of complications. The procedure is also associated with a marked improvement in obesity-related comorbidities.

Laryngeal mask airway vs. uncuffed endotracheal tube for nasal and paranasal sinus surgery: paediatric airway protection.

BACKGROUND AND OBJECTIVE: Risks are anticipated for laryngeal mask airway (LMA) anaesthesia during nasal and sinus surgeries because blood can trickle posteriorly into the hypopharynx and contaminate the airway. This study was conducted to determine whether a LMA could provide adequate airway protection from the expected intraoperative bleeding. METHODS: After obtaining ethics committee approval, 60 children ASA status I or II, 1-12 years of age, and scheduled for nasal and sinus surgery were randomized to one of two groups, endotracheal tube (ETT) or LMA, with 30 patients in each. Topical lidocaine with adrenaline was used in all patients, and throat packs were used for the ETT group. The airway was examined using a fibreoptic endoscope in order to determine whether blood or tissue debris soiled the supraglottic airway or trachea. After extubation, LMAs and ETTs were examined for soiling by blood and graded on a scale of 0-3. For ETT, the grades were 0, none; 1, contamination above the mark for vocal cord depth; 2, contamination below the mark for vocal cord depth; and 3, contamination interiorly. For LMA, they were 0, no staining; 1, staining on the anterior aspect of the cuff of the LMA; 2, staining inside the cup of the LMA; and 3, staining found in the tube. RESULTS: Blood stains were found in the larynx of one child in the LMA group. In the ETT group, there were three cases of staining (two supraglottic and one in the trachea, P = 0.161). With the LMA, 12 (40%) and 18 (60%) patients had visual contamination scores of 0 and 1, respectively. With the ETT, 14 (46.7%), 10 (33.3%), and six (20%) patients had visual contamination scores of 0, 1, and 2, respectively (P = 0.0123). CONCLUSION: LMA is a suitable method for paediatric patients undergoing sinonasal surgery because it offers airway protection from blood contamination comparable to that of a standard uncuffed ETT with throat pack.

Comparison of the outer diameter of the 'best-fit' endotracheal tube with MRI-measured airway diameter at the cricoid level.

BACKGROUND AND OBJECTIVE: In this study, we evaluated the ratio of the outer diameter of an uncuffed Mallinckrodt endotracheal tube (ETT, Mallinckrodt Tyco Healthcare UK Ltd) to the MRI-measured internal transverse airway diameter (ITD) at the cricoid level in children. METHODS: With institutional ethics committee approval and parental consent, we measured the ITD at the cricoid level from MRI images of children undergoing MRI diagnostic procedures requiring general anaesthesia with orotracheal intubation. The ITD at the cricoid level was compared with the outer diameter of the utilized ETT. Linear regression analysis was employed to assess the correlation of tracheal diameter with age, height and weight. For all tests, a P value of less than 0.05 was considered to be statistically significant. RESULTS: Fifty patients were studied (21 girls and 29 boys). The difference between the ITD at the cricoid level and the outer tracheal tube diameter ranged from 0.1 to 1.7 mm (median 0.7 mm). The internal transverse tracheal diameters had a strong association with age (r=0.7077, P<0.001), a moderate association with height (r=0.5928, P<0.001), and a mild association with weight (r=0.2437, P<0.001). CONCLUSION: The outer diameter of the 'best-fit' ETT was less than the ITD at the cricoid level by 0.1-1.7 mm. The correlation of the outer diameter of the 'best-fit' ETT with age was stronger than with height or weight.