Identifying the obstacles facing emergency nurses regarding treating CTAS1 and CTAS2 in Saudi Arabia.

BACKGROUND: Emergency nurses play a pivotal role in delivering efficient emergency healthcare, yet they often encounter numerous challenges, especially while managing life-threatening cases, impacting both their well-being and patient satisfaction. This study seeks to identify the prevalent challenges faced by these nurses in Saudi hospitals when handling Canadian Triage and Acuity Scale (CTAS1 and CTAS2) cases, with the aim of mitigating or managing these issues in the future. METHODS: This study incorporated a mixed-method approach to identify obstacles in Emergency Department (ED) nursing treatment of CTAS1 and CTAS2 cases in two major Saudi Arabian hospitals. The research began with qualitative focus group interviews with expert ED nurses, followed by a quantitative survey to measure and explore relationships among the qualitative findings. Data analysis leveraged qualitative thematic analysis and principal component analysis, ensuring rigorous examination and validation of data to drive meaningful conclusions. FINDINGS: From expert interviews, key challenges for emergency nurses were identified, including resource management, communication, training compliance, and psychological factors. A survey of 172 nurses further distilled these into five major issues: patient care management, handling critical cases, administration support, patient care delay, and stress from patients' families. CONCLUSION: Through a mixed-method approach, this study pinpoints five pivotal challenges confronting emergency nurses in Saudi hospitals. These encompass difficulties in patient care management, the psychological toll of handling critical cases, inadequate administrative support, delays due to extended patient stays, and the stress induced by the presence of patients' families, all of which significantly impede emergency department efficiency and compromise nurse well-being.

Assessment of the relationship between impacted mandibular third molars' angulation pattern and crowding severity: A cross-sectional study.

Mandibular crowding is the most common type of dental crowding among adolescents. Aims: To investigate the relationship between the angulation pattern of impacted mandibular third molars and the severity of mandibular anterior crowding. Methodology: A total of 69 participants with impacted mandibular third molars were included in the study, and their records were analysed. Results: There was no significant association between impacted mandibular third molars' angulation pattern and mandibular anterior crowding severity, as well as no correlation between gender and either impacted mandibular third molars' angulation pattern or mandibular anterior crowding severity. Conclusion: Our findings suggest that the angulation pattern of impacted mandibular third molars is not a significant contributing factor to the severity of mandibular anterior crowding. However, further studies with larger sample sizes are necessary to validate these results.

Modified Dose of Radioactive Iodine Therapy in a Patient With Thyroid Cancer on Peritoneal Dialysis: Case Report and Review of Literature.

Thyroid malignancy is common among patients with renal impairment compared with the general population. Treatment involves surgical resection and radioactive iodine therapy (RAI) in high-risk patients. As a result of impaired iodine clearance in those with no residual kidney function, the determination of appropriate iodine dose is challenging. Evidence is lacking, and all previous reports are based on case studies with no universally accepted protocol.  We describe the case of a 30-year-old woman with end-stage renal disease on peritoneal dialysis (PD) who was diagnosed with papillary thyroid cancer while undergoing a pre-kidney transplant workup. She had a total thyroidectomy with modified radical neck dissection followed by a reduced-dose radioactive iodine therapy of 30 mCi based on her residual kidney function. Her PD prescription was adjusted to achieve a 2 L ultrafiltration daily. One year follow-up confirmed no evidence of residual nor recurrent disease. High-risk patients with differentiated thyroid malignancy require adjuvant radioactive iodine therapy. The optimal dose of RAI in the end-stage renal disease population is controversial. There are no clear guidelines available for patients with end-stage kidney disease including patients on peritoneal dialysis. Reduced dose therapy is probably effective in achieving the goals of therapy, with lower toxic risk to internal organs. Determining the appropriate schedule of each dialysis session in relation to RAI, the specific replacement prescription, and establishing a safe environment for medical staff dealing with such patients is important to consider. This article aims to highlight the need to establish a standardized protocol among patients with reduced kidney function treated with iodine therapy.

Knowledge and Awareness of Syncope Among General Populations of Makkah Region in Saudi Arabia: A Cross-Sectional Study.

Background Syncope is a transient loss of consciousness and postural tone due to global cerebral hypoperfusion which is followed by spontaneous recovery. It is relatively common and increases the risk of subsequent falls and injury. There is scant literature and targeted research on the population's knowledge of syncope. Hence, this study aimed to assess awareness and evaluate the knowledge of syncope among the population of the Makkah region. Methodology An online cross-sectional study was done on 563 participants. A questionnaire was used to collect data about participants' demographics, experiencing syncope in relatives, and knowledge about syncope using case scenarios. Results Females represented 72.6% of the participants and about one third of participants admitted that they had experienced syncope throughout their life. About one-third of participants admitted that they had experienced syncope throughout their life. Most of the study participants (68.9%) showed a good level of knowledge about syncope while 31.1% of them had poor knowledge; the average awareness score was 5.3±1.64. Cardiogenic syncope was the most commonly recognized type of syncope. Furthermore, participants aged between 18 and 35 years and widowed participants demonstrated a good amount of knowledge about syncopal attacks (p<0.001). Conclusions General population of the Makkah region in Saudi Arabia had a sufficient level of knowledge about syncope. Additional studies along with educational programs are needed.

Epidemiological Characteristics and Outcome of Open Globe Injuries in Tabuk City, Kingdom of Saudi Arabia: Retrospective Cohort Study.

INTRODUCTION: The objective of this study was to assess the epidemiological characteristics, clinical features and visual outcomes of open globe eye injury (OGI) in Tabuk, Saudi Arabia. METHODS: A retrospective chart review of OGI patients who had undergone operative repair of their injuries in Tabuk, Saudi Arabia. The collected data included patients' demographics, duration between trauma and presentation and the mechanism of trauma, wound location, extent of injury, presence of intraocular foreign body, and initial and final visual acuity data. RESULTS: Sixty-three eyes of 63 patients who were admitted for traumatic globe rupture were included; 84.1% were males and 39.7% were of pediatric age. Delay in seeking medical care for > 24 h was recorded in 4.8% of patients. The most common (42.9%) mechanism was blunt trauma followed by sharp trauma (38.1%) and projectile trauma (9.5%); 55.6% had the injury in zone 1. Intraocular foreign body was reported in 9.5% of patients. Intraocular foreign bodies were significantly more common in adults (p = 0.018) compared to children. Poor visual acuity was noted in 77.8% of patients upon presentation and 60.3% on last visit. CONCLUSION: The incidence of OGI was more common in males. The most common cause of OGI was blunt injury, and half of the injuries were in zone 1. Visual outcomes are guarded for most patients with OGIs.

Postharvest disease management of Alternaria spots on tomato fruit by Annona muricata fruit extracts.

The aim of this study was to assess Annona muricata L. fruit extracts as an alternative to synthetic fungicide against Alternaria alternata (Fries) Keissler, the causative agent of black spots of tomato fruit. Antifungal activities of A. muricata pulp and seed extracts were tested both in vitro and in vivo. The seed extracts were more potent at inhibiting A. alternata than the pulp extracts. The in vitro assay showed maximum inhibition of radial mycelial growth of A. alternata (90%) by methanol seed extracts, at the highest concentration of 6%. Similarly, the in vivo assay showed marked reduction in lesion diameter (2.1 mm) and consequent disease inhibition (84%) on the tomato fruit treated with methanol seed extracts. Scanning electron microscopy showed that A. muricata extracts significantly damaged the morphology of hyphae and conidial structures. The FT-IR spectrum obtained from methanol extracts showed bands representing important bioactive compounds that possess antifungal activity. Based on our findings, Annona muricata fruit extracts can be further explored as a potential, excellent alternative approach to control the postharvest Alternaria spots of tomato fruit.