Saudi Journal of Medicine and Public Health
Saudi Journal of Medicine and Public Health (SJMPH) is a biannual, peer-reviewed, gold open-access journal based in Saudi Arabia. The journal is dedicated to advancing scientific knowledge in clinical medicine, public health, epidemiology, health policy, disease prevention, and related disciplines. SJMPH publishes original research articles, systematic reviews, case reports, and brief communications in both English and Arabic. All articles are made freely available under the Creative Commons Attribution 4.0 International (CC BY 4.0) license, allowing for unrestricted use, distribution, and reproduction with proper attribution. The journal is hosted on the Open Journal Systems (OJS) platform and adheres to the highest editorial standards through a rigorous double-blind peer review process and the use of advanced plagiarism detection tools. SJMPH is indexed in Google Scholar and accredited by the Saudi Ministry of Media and the King Fahad National Library.
Mutlaq Al-Injaz Library Foundation for Copying and Photocopying
Occipital Brain Abscess with Obstructive Hydrocephalus Caused by Streptococcus anginosus in a 24-Year-Old Male: A Case Report
Background: Brain abscesses are severe intracranial infections with significant morbidity and mortality. The Streptococcus anginosus group (SAG), known for its abscess-forming potential in deep tissues, rarely causes central nervous system (CNS) infections. Case Presentation: We report a 24-year-old immunocompetent male presenting with high-grade fever, headache, vomiting, and confusion. Imaging revealed a right occipital lobe abscess with obstructive hydrocephalus. Cerebrospinal fluid culture grew S. anginosus, confirming the diagnosis. The patient underwent emergency insertion of an external ventricular drain and received empirical meropenem and vancomycin, later de-escalated to cefotaxime based on sensitivity testing. Follow-up imaging demonstrated complete abscess resolution after six weeks of antibiotic therapy. Discussion: This case represents, to our knowledge, the first documented S. anginosus brain abscess in Saudi Arabia. The pathogen’s ability to produce tissue-invasive enzymes and biofilms contributes to its virulence. While streptococci are frequently isolated from brain abscesses in the region, species-level identification is often lacking, leading to underreporting of SAG-related infections. Early neuroimaging, microbiological identification, and combined surgical-antibiotic management are crucial for favorable outcomes. Conclusion: S. anginosus should be considered a potential cause of brain abscesses, even in healthy individuals. Routine species-level microbiological analysis is essential for accurate diagnosis, targeted therapy, and improved epidemiological understanding.
Copyright (c) 2025 Sirajo Tambuwal, Seriehan Mubarak Alshammari, Mubarak Alhumaidi Alshammari https://creativecommons.org/licenses/by/4.0
Interprofessional Approaches to the Prevention and Management of Nosocomial Infections: Integrating Pharmacological, Administrative, and Nursing Perspectives
Background: Healthcare-associated infections (HAIs) represent a major global public health challenge, contributing significantly to patient morbidity, mortality, and healthcare costs. These infections, acquired during the course of medical care, are frequently caused by multidrug-resistant organisms and are linked to invasive procedures and devices. Aim: This article aims to synthesize a comprehensive, interprofessional approach to the prevention and management of HAIs, integrating the distinct yet complementary roles of pharmacological, administrative, and nursing perspectives to improve patient safety and outcomes. Methods: The review consolidates evidence on the etiology, epidemiology, and pathophysiology of major HAIs—including central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), surgical site infections (SSI), and pneumonia (HAP/VAP). It evaluates management strategies centered on rapid diagnosis, source control, and targeted antimicrobial therapy, underpinned by robust infection prevention and control (IPC) protocols. Results: Effective management hinges on a triad of rapid source control, timely and pathogen-directed antimicrobial therapy, and unwavering adherence to prevention bundles. Key outcomes include reduced infection rates, shorter hospital stays, lower mortality, and decreased antimicrobial resistance. The success of these measures is fundamentally dependent on seamless interprofessional collaboration. Conclusion: A unified, interprofessional model is paramount for combating HAIs. This model integrates antimicrobial stewardship from pharmacists, rigorous implementation of IPC protocols by nursing staff, and supportive policy and resource allocation from administrators to create a safer healthcare environment.
Copyright (c) 2025 Khadijah Ahmad Abdallh Bin Zarah, Amnah Hamood Althalabi, Mohammed Muqbil Alqahtani, Saad Musaad Z Alotaibi, Saad Abdulaziz Alrabiah , Khalid Ayidh Muqbil Alotaibi, Mohammed Muqbil Alqahtani, Abdullah Faraj Hijab Al-Otaibi, Mohammed Ali Mousa Dreab, Zahra Ali Mohsin Alnakhli, Nadiyah Dallaj M Almutairi https://creativecommons.org/licenses/by/4.0
knee osteoarthritis: An Updated Review for Physical Therapists, Nursing, and Pharmacists
Background: Knee Osteoarthritis (KOA) is a prevalent, degenerative joint disease and a leading cause of pain and disability globally. Its management is a significant challenge for healthcare systems, necessitating effective, conservative strategies to alleviate symptoms and improve function. Aim: This review aims to provide an updated, comprehensive analysis of the efficacy, mechanisms, and comparative value of various physical therapy modalities for KOA, tailored for physical therapists, nurses, and pharmacists involved in patient care. Methods: The article employs a systematic literature review methodology, evaluating a range of physical therapy interventions. These include traditional techniques like acupuncture and moxibustion, and modern modalities such as therapeutic ultrasound, shortwave diathermy, Pulsed Electromagnetic Field (PEMF) therapy, low-intensity laser therapy, and electrotherapy across low-, mid-, and high-frequency ranges. Results: The analysis confirms that all reviewed modalities can effectively reduce pain and improve function in KOA patients. Each therapy operates through distinct mechanisms—neuromodulation, thermal effects, photobiomodulation, or electromagnetic stimulation. The review highlights that combining modalities with complementary mechanisms often yields superior, synergistic outcomes compared to monotherapy. Conclusion: There is no single superior physical therapy for all KOA patients. A pragmatic, multimodal approach is recommended, integrating foundational exercise and education with accessible, low-cost options (e.g., moxibustion, electrotherapy) and escalating to technology-intensive modalities (e.g., PEMF, laser) based on individual patient needs, clinical phenotype, and resource availability.
Copyright (c) 2025 Hussa Fraih Moodhi Alharbi, Rabab Mohammed Ali Alsaleh, Yasir Mohammed Mousa Alajam, ‏Salman Hassan Mohammed Alhathiq, Rashed Sultan Ali Alonazi, Faisal Abdullah Al Faisal , Nasser Abdullah D Alkhurayyif, Abdulaziz Ibrahim M Alfaisal , Fahd Mohammed Alharbi, Abdulrahman Mohammed Hakami, Faisal Awad Alshan, Beshaeir Bandar Bin Jamaan, Malak Hadi Ibrahim Jaafari https://creativecommons.org/licenses/by/4.0
Navigating the Labyrinth: A Systematic Review of Role Clarity and Scope of Practice Among Diverse Healthcare Providers
Background: The contemporary health care system is characterized by increasing patient complexity, unprecedented workforce shortfalls, and a requisite shift toward interprofessional, team-based models of care. Well-defined roles and scopes of practice for all health professionals are key elements underpinning patient safety, team effectiveness, and professional well-being within this dynamic. Aim: This systematic review aims to synthesize current literature from 2015 to 2025, exploring and comparing issues of role clarity and SoP among five key provider groups: midwives, GPs, nurses, dentists, and health assistants. Methods: A systematic search across major electronic databases, such as PubMed/MEDLINE, CINAHL, and Scopus, was conducted for relevant literature published within the period 2015-2025. The review included only peer-reviewed original research, systematic reviews, and meta-analyses focusing on either role clarity or SoP in clinical practice settings for the specified provider groups. Results: The findings show that role ambiguity is a universal yet distinctive challenge across professions. Key issues pertain to midwives on their autonomy with obstetricians, GPs on their role expansion and delegation, nurses on the blurring of boundaries with advanced practice, dentists on systemic integration, and health assistants on pervasive ambiguity. Cross-cutting themes to influence clarity are regulatory frameworks, interprofessional education, intra-professional differentiation, and organizational culture. Conclusion: Role clarity is a dynamic process that is necessary for effective teamwork. It requires updated regulations, focused interprofessional education and leadership, and a particular emphasis on the integration of health assistants. Such initiatives are core to ensuring team performance is optimized, care for patients is improved, and provider retention is enhanced.
Copyright (c) 2025 Saadah Hameed Mohammed Alfahmi, Abdulrahman Hamad Al Rutaiq, Nada Ahmad Alhejali, Maryam Salem Algarni, Waad Saad Aldossari, Abdullah Kallas Arishi, Shaewela Mosa G Alanazi, Abdulaziz Farrah Andejani, Alia Abdulaziz Alkhelb, Shikah Saad Aldosary, Salwa Salem Alanazi, Shatha Ahmed Alaryani, Asma Mosa G Alanazi, Amal Mohammed ibn Mandeel https://creativecommons.org/licenses/by/4.0
Acute Pancreatitis: CT Severity Index, Fluid-Resuscitation Nursing Algorithms, and Lipase/CRP as Outcome Markers
Background: Acute pancreatitis (AP) is a common, potentially life-threatening inflammatory condition with heterogeneous etiologies and trajectories. Early risk stratification and coordinated supportive care are pivotal to reduce necrosis, organ failure, and resource use. Aim: To synthesize evidence on three practical pillars of inpatient AP care—radiologic grading by CT Severity Index (CTSI), fluid-resuscitation nursing algorithms, and biochemical markers (lipase and C-reactive protein, CRP)—and to propose an integrated, bedside-ready framework. Methods: Narrative review of contemporary diagnostic and management domains summarized in this article, emphasizing: (1) imaging roles (ultrasound/CECT/MRI) and CTSI for local complications; (2) nurse-led fluid protocols (targets, choice of crystalloid, ROSE phases); and (3) serial lipase/CRP as outcome markers alongside clinical severity classifications. Results: CTSI reliably stages local pancreatic/peripancreatic complications and complements clinical systems (e.g., RAC/DBC) for prognostication and timing of interventions. Nurse-delivered resuscitation algorithms with early lactated Ringer’s at 5–10 mL/kg/h, dynamic endpoints (heart rate <120 beats/min, urine output >0.5 mL/kg/h), and avoidance of overload reduce SIRS, organ failure, and length of stay. Early enteral nutrition embedded in nursing pathways improves tolerance and pain trajectories. Lipase confirms diagnosis but trends add limited prognostic value; CRP trajectories (e.g., 48–72 h) better correlate with severity and necrosis, especially when interpreted with imaging and physiology. Multidisciplinary coordination among radiology, laboratory, and nursing closes operational gaps and accelerates definitive etiologic care. Conclusion: An integrated pathway combining CTSI-guided imaging, protocolized nurse-led fluid resuscitation, and judicious use of lipase/CRP improves risk recognition, streamlines decisions, and may reduce complications and costs in AP.
Copyright (c) 2025 Abdulmohsen Ateeq Alamari, Adel Garsan Seed Alzahrani, Fahad Mohmmed Saead Alqhtani, Fatimah Mousa Ibrahim Alsekiny, Adel Maqbul Mutlaq Alsharar, Hussain Homoud Habibi Namazi, Mohammed Ahmed Mohammed Muyidi , Ahmed Saud Alhejaili, Hosam Hasan Alzhrani , Wazan Maeid Al-Anzi https://creativecommons.org/licenses/by/4.0
Recognizing Tension Pneumothorax: A Comprehensive Guide for Paramedics and Emergency Professionals
Background: Tension pneumothorax is a life-threatening condition characterized by the progressive accumulation of air within the pleural space, leading to a positive pressure that displaces mediastinal structures, impairs venous return, and causes cardiovascular collapse. It represents a critical emergency across prehospital, emergency department, and intensive care settings, requiring immediate recognition and intervention to prevent mortality. Aim: This comprehensive guide aims to educate paramedics and emergency professionals on the pathophysiology, rapid clinical identification, and emergent management of tension pneumothorax to improve patient outcomes. Methods: The article synthesizes current medical knowledge on tension pneumothorax, detailing its etiology (traumatic, iatrogenic, and spontaneous), pathophysiology, and diagnostic approaches. Evaluation methods, including point-of-care ultrasound and chest X-ray for stable patients, are reviewed, with an emphasis on clinical diagnosis for unstable patients. Results: The findings underscore that tension pneumothorax is a clinical diagnosis. Key signs include respiratory distress, hypotension, unilateral absent breath sounds, and tracheal deviation. Immediate needle decompression, typically in the anterior axillary line, is the critical first intervention, followed by definitive chest tube thoracostomy. Delays in decompression are directly linked to increased mortality. Conclusion: Proficiency in the rapid recognition and immediate management of tension pneumothorax is a fundamental competency for frontline clinicians. Successful outcomes depend on a high index of suspicion, prompt needle decompression without awaiting imaging, and coordinated interprofessional care for definitive treatment and complication management.
Copyright (c) 2025 Wael Abdullah Alharbi, Eid Salem Muaythif Alhazmi, Amjad Mudhayyif Alsufyani, Rashed Ali Alhutaylah, Ibrahim Jobran Moafa, Shadi Abdullah Hamzi https://creativecommons.org/licenses/by/4.0
Comprehensive Clinical Management of Atrial Septal Defect: A Multidisciplinary Approach Bridging Nursing, Radiology, and Laboratory Sciences
Background: Atrial Septal Defect (ASD) is a common congenital heart anomaly characterized by a persistent interatrial communication, leading to a left-to-right shunt. If left untreated, significant defects can cause right heart volume overload, pulmonary hypertension, atrial arrhythmias, and heart failure. Aim: This article aims to provide a comprehensive overview of the clinical management of ASD, emphasizing a multidisciplinary approach that integrates insights from nursing, radiology, and laboratory sciences to optimize patient outcomes from diagnosis through long-term follow-up. Methods: The review synthesizes current knowledge on ASD, covering its etiology, epidemiology, pathophysiology, and clinical presentation. It details the diagnostic evaluation, primarily via transthoracic and transesophageal echocardiography, with advanced cross-sectional imaging (CT/MRI) for complex cases. Management strategies, including conservative surveillance, percutaneous device closure for suitable secundum defects, and surgical repair for complex anatomies, are examined. Results: Small ASDs may close spontaneously, but hemodynamically significant defects (Qp/Qs >1.5) require intervention to prevent complications. Percutaneous closure is effective for secundum defects with adequate rims, while surgical repair is necessary for primum, sinus venosus, and coronary sinus defects. Timely closure typically leads to reverse right heart remodeling and excellent long-term prognosis, whereas delayed treatment risks irreversible pulmonary vascular disease (Eisenmenger syndrome). Conclusion: Effective ASD management relies on accurate anatomic and hemodynamic assessment to guide intervention. A coordinated, multidisciplinary team is essential for timely diagnosis, appropriate selection of closure method, and lifelong patient surveillance to prevent complications and ensure optimal quality of life.
Copyright (c) 2025 Nouf Ibrahim Ahmad Alknani, Ali Humood Salah Alharbi, Ahlam Abdullah Hakami, Al Anoud Abdullah Al Qarni, Abdullah Khalif Alanazi, Alfaten Khalf Alshammri, Eman Kuliab Aldhafeery, Amnah Hassan Ahmed Asuni, Tuqa Musaad Alahmadi, Ibrahim Ahmed Khabrani, Abdullrahman Saad Rathaan Aldhafeeri, Jaiz Nahi Nawi Aldoferi, RAHMAH TANI SHARA AL DOSARI https://creativecommons.org/licenses/by/4.0
The Pivotal Role of Nursing Leadership in Hospital Health Management and Quality Improvement Initiatives: A Comprehensive Review
Background: The healthcare context in which nurses practise is increasingly complex, with financial pressures and a continued demand for high-quality, safe patient care. It is in this context that nursing leadership can no longer be regarded solely as a supportive discipline but as integral to organizational performance. Aim: To synthesize and critically analyze existing literature on the role of nursing leadership in health management and quality improvement initiatives within a hospital. Methods: A systematic narrative review methodology was adopted. A comprehensive search of electronic databases for peer-reviewed literature between the years 2000 and 2024 was carried out. Keywords included "nursing leadership," "quality improvement," "patient safety," "health management," "transformational leadership," and "hospital." Studies that met the review inclusion criteria were thematically analyzed. Results: Several pivotal nursing leadership roles were identified through the analysis, including: 1) establishing a safety culture and continuous improvement; 2) implementing and sustaining evidence-based practice (EBP); 3) applying strategic leadership styles, notably transformational and resonant leadership; 4) optimizing human resources management, including staffing and retention; and 5) using data related to performance monitoring. Conclusion: Nursing leadership is an indispensable part of effective hospital health management. Evidence clearly indicates that strong, strategic, and supportive nursing leadership development is not an optional luxury but a core essential for the pursuit of excellence in patient care and the long-term sustainability of healthcare organizations.
Copyright (c) 2025 Hana Eid Ali Al-Mawlid, Salha Mohmmed Al Garni, Saeed Ali S Alzahrani, Mansour Bakheet Alshanbari, Rawan Mansour Ali Sarhan, Seham Mohammad Abdoalrahman Alhawsawi, Khadijah Ahmad Abdallh bin Zarah, Amnah Hamood Althalabi https://creativecommons.org/licenses/by/4.0
Integrated Public Health and Nursing Approaches in the Prevention and Management of Dental Trauma in Children: A Multidisciplinary Perspective
Background: Traumatic Dental Injuries (TDIs) are a highly prevalent global public health issue in children, with lifetime rates of 20-30%. These injuries, often affecting the maxillary incisors, can lead to severe complications like pulp necrosis and root resorption, causing lasting functional, aesthetic, and psychosocial consequences that impair a child's quality of life. Aim: This article aims to synthesize a comprehensive, multidisciplinary approach to the prevention and management of pediatric dental trauma, integrating perspectives from dentistry, nursing, and public health to improve clinical outcomes and reduce health disparities. Methods: The review examines the etiology, risk factors, and classification of TDIs using International Association of Dental Traumatology (IADT) guidelines. It evaluates diagnostic methods, including traditional clinical exams and advanced perfusion-based technologies like laser Doppler flowmetry and pulse oximetry. Treatment strategies for primary and permanent teeth are analyzed, alongside preventive public health interventions and the psychological impact of trauma. Results: TDIs are influenced by age-specific behaviors and socioeconomic factors, with significant disparities in care access. Accurate diagnosis is enhanced by perfusion-based vitality tests, which are more reliable than traditional methods in children. Management is staged and biology-focused, prioritizing pulp preservation in young permanent teeth. Effective prevention requires educational programs for caregivers and school personnel, policy mandates for mouthguards in sports, and digital health tools to guide first responders. Conclusion: A coordinated, multidisciplinary strategy that bridges clinical dentistry, nursing, and public health is essential to mitigate the incidence and long-term sequelae of pediatric dental trauma. This integrated approach ensures timely intervention, equitable access to care, and improved psychosocial and functional outcomes for children worldwide.
Copyright (c) 2025 Ola Omar Alsaeed, Fahad Mana Almani, Abdulilah Ibrahim Alabdullatif , Abdullah Sultan Alotaibi, Waleed Saud Jeleudan, Munirah Fatis Alshahrani, Abeer Kheder Albishi, Badrieah Saud N Alesaimi, Amjad Mudhayyif Alsufyani, Monif Dhaher Thani Almutrafi https://creativecommons.org/licenses/by/4.0
Interdisciplinary Innovations in the Management of Pediatric Mandibular Fractures: Integrating Dental, Radiological, and Nursing Perspectives
Background: Pediatric mandibular fractures present unique challenges due to the presence of developing tooth buds, evolving occlusion, and the dynamic growth potential of the jaw. Management must balance achieving stable fixation with preserving long-term growth and function, necessitating a departure from standard adult protocols. Aim: This article aims to present and evaluate a conservative, interdisciplinary approach to managing pediatric mandibular fractures, focusing on techniques that minimize iatrogenic harm to dental and growth structures while ensuring effective healing. Methods: The methods are illustrated through a series of case studies (ages 1.5 to 16 years) involving mandibular fractures. The primary technique involved closed reduction using a custom-molded impression compound splint secured with circummandibular wiring, often combined with bridle wiring for concomitant dental injuries. This approach is contrasted with other methods like intermaxillary fixation (IMF) with interdental hooks in older children. Results: The presented technique proved highly effective across all cases. It provided stable, non-rigid fixation, achieved satisfactory fracture alignment, and facilitated uncomplicated healing. Key outcomes included the restoration of normal occlusion, rapid return to function, and the absence of complications such as infection or injury to tooth buds. The method was also noted for its procedural efficiency, cost-effectiveness, and ease of removal. Conclusion: A conservative strategy utilizing impression compound splints and circummandibular wiring is a safe, reliable, and biologically sound option for pediatric mandibular fracture management. Its success underscores the critical importance of an interdisciplinary team integrating dental, surgical, radiological, and nursing expertise to optimize outcomes for the growing patient.
Copyright (c) 2025 Dhabha Dauod Alenizi, Dalal Nasser Alharbi, Ashwaq Mohammed Haddadi, Aeshah Ali Salem Albalawi, Bayan Ahmed Mabrook Alkhred, Ali Humood Salah Alharbi, Mohammed Yahya Alfifi , Jawaher Homoud Alanazi , Abdulrahman Saad Bijad Alsubaie, Mohammed Ayad Al Harbi , Badreah Ahmad Alhadidi, Maryam Essa Ayyashi https://creativecommons.org/licenses/by/4.0
The Dual Burden of Malnutrition and Oral Disease: An Updated Framework for Family Medicine, Dental Care, Nutrition Care, and Community Health Security
Background: The aging population faces a complex, bidirectional relationship between oral health and nutritional status. Age-related physiological decline, compounded by oral diseases like periodontitis, caries, and xerostomia, directly impairs masticatory function, leading to poor nutrition. This, in turn, accelerates systemic conditions like sarcopenia and frailty, creating a vicious cycle of decline. Aim: This review aims to synthesize an updated framework elucidating the interconnected pathways between oral dysfunction and malnutrition, and to propose integrated, multidisciplinary intervention strategies for family medicine, dental care, and community health. Methods: The article employs a comprehensive literature review methodology, analyzing the impact of specific oral conditions (edentulism, dry mouth, periodontal disease) on dietary intake and nutritional biomarkers. It further examines the shared pathophysiology, such as chronic inflammation, that links oral disease to systemic muscle loss (sarcopenia). Results: The analysis confirms that poor oral health is a primary driver of malnutrition in older adults, leading to reduced intake of protein, fiber, and essential micronutrients. Concurrently, oral inflammatory diseases exacerbate systemic inflammation, directly contributing to sarcopenia and frailty, thereby increasing disability and mortality risk. Conclusion: Breaking the cycle of oral disease and malnutrition requires a collaborative, person-centered approach. Effective management integrates dental rehabilitation, personalized nutrition, and physical therapy within a Comprehensive Geriatric Assessment framework.
Copyright (c) 2025 Intisar Kalaf Albalawi, Mugbil Mohammed Alotaibi, Fedha Khamis Nasser Abadi, Ali Bader Apsulami, Azzah Atitallah Ali Alzahrani , Abdullah Ali Mutair Alzahrani, Abdulaziz Saeed Alghamdi, Mohammed Hebah Badawi, Ahmad Abdulsattar Zaghoun, Marwan Saud Alharbi, Mathail Lafi Alanazi https://creativecommons.org/licenses/by/4.0
Coordinated Healthcare Management for Chronic Diseases: Linking Nursing Leadership, Medical Record Systems, and Public Health Administration
Background: Chronic disease management in the U.S. is hindered by fragmented services, leading to preventable adverse events, duplicative testing, and rising costs. Coordinated care—anchored in nursing leadership, interoperable medical records, and public health administration—has been linked to better outcomes and system efficiencies. Aim: To synthesize an integrated framework for coordinated healthcare management of chronic diseases that links nurse-led care coordination, electronic health record (EHR) connectivity, and public health/administrative structures, and to illustrate its clinical impact. Methods: Narrative synthesis of empirical studies and implementation guidance on care coordination, interprofessional collaboration, and health information technology; application of the Care Coordination Model within an Accountable Care Organization (ACO) to a representative clinical case. Results: Studies demonstrate that lapses in coordination increase preventable events and missed diagnoses, whereas comprehensive coordination in high-risk populations reduces total medical spending (via fewer admissions and shorter stays). Operational enablers include: clear accountability (designated coordinators/navigators), patient support (education, navigation, social needs), durable referral compacts across settings, and EHR-enabled information exchange (e-referrals, e-consults, shared care plans). A case exemplar showed rapid specialty access, closed-loop communication, and measurable improvement in glycemic control (A1C 7.7%→6.2% in four months) following coordinated cardiology, nursing, and dietetics care. Persistent challenges include fee-for-service misalignment, payer network complexity, and EHR interoperability gaps; value-based contracts and standardized workflows mitigate these barriers. Conclusion: An integrated, nurse-led, information-connected coordination model—embedded within ACO or similar structures—improves safety, experience, and value for patients with chronic disease while advancing population health goals.
Copyright (c) 2025 Alwaleed Hussain Alharbi, Yazeed Mohammed Alanazi, Mohammed Hassan Al Salem, Hadi Bader Alkhazal, Bader Mohammed Alothman, Tahani Abdulhadi Alajmi, Ahmed Saeed Saleh Alzahrani, Younes Abdulkareem Mohammed Alsowelem, Khalid abdulaziz Alotaibi, Ahmed Attiah alzahrani https://creativecommons.org/licenses/by/4.0
Integrated Medical and Nursing Perspectives in the Emergency Management of Venous Gas Embolism: A Multidisciplinary Clinical Approach
Background: Venous Gas Embolism (VGE) is a critical condition characterized by the entrainment of gas into the venous system, often due to iatrogenic causes like central venous catheterization and neurosurgery. It can lead to right ventricular outflow obstruction, cardiovascular collapse, and, via paradoxical embolism, systemic end-organ ischemia. Aim: This article aims to synthesize an integrated, multidisciplinary approach to the emergency management of VGE, emphasizing the collaborative roles of medicine and nursing in rapid diagnosis, stabilization, and treatment to improve patient outcomes. Methods: The review examines the pathophysiology, etiology, and clinical presentation of VGE. It evaluates diagnostic modalities, including continuous capnography and echocardiography, and details a structured management protocol involving immediate source control, patient repositioning, hemodynamic support, and aspiration of intracardiac air. Results: VGE presents with a spectrum of symptoms, from subtle changes in end-tidal CO₂ to fulminant cardiovascular collapse. Key interventions—administering 100% oxygen, placing the patient in the left lateral decubitus position, and aspirating air via a central venous catheter—are time-critical. Hyperbaric oxygen therapy is a crucial adjunct for severe cases, particularly those with neurological involvement. Conclusion: Successful management of VGE hinges on a high index of suspicion and immediate, coordinated action by a multidisciplinary team. A protocolized response that integrates medical and nursing expertise is essential to mitigate this life-threatening emergency's high morbidity and mortality.
Copyright (c) 2025 Mutual Mohamad Khalaf Alrougy, Monif Dhaher Thani Almutrafi, Abdullah Amer B Aldosari, Mona Abolghith Umar Qdaimi, Sarah Mubarak M Aldawsari, Salha Mohammed Al-Thrwy, Fahad Bandar Almutairi, Azzah Atitallah Ali Alzahrani, Sahar Saad Saed Alshahrani, Guzail Masfer Alotibi, Afaf Hassan Alnami, Khalid Nasser Aldhahran https://creativecommons.org/licenses/by/4.0
Role of Human Papillomavirus (HPV) in the Development and Progression of Cervical Cancer
Cervical cancer remains a major cause of morbidity and mortality, disproportionately affecting women in low- and middle-income countries despite its high preventability. Persistent infection with high-risk human papillomavirus (hrHPV), particularly genotypes 16 and 18, is a necessary causal factor in cervical carcinogenesis. This review synthesizes current evidence on the role of HPV in the initiation and progression of cervical cancer, spanning viral biology, molecular pathogenesis, host determinants, and clinical implications. We summarize HPV structure, classification, transmission, and natural history, highlighting how the E6 and E7 oncoproteins disrupt p53 and pRb pathways, drive genomic instability, and interact with host epigenetic and DNA damage-response machinery. We also examine host genetic susceptibility, hormonal influences, smoking, HIV-associated immunosuppression, cervicovaginal dysbiosis, micronutrient deficiencies, and immune evasion mechanisms that condition progression from transient infection to high-grade lesions and invasive cancer. Finally, we review advances in HPV-based screening, biomarkers, and prophylactic and therapeutic vaccination, and discuss how HPV status and genotype inform prognosis and treatment response. Understanding these viral–host interactions is essential for optimizing implementation of the WHO 90-70-90 strategy and for designing context-appropriate interventions to reduce persistent global inequities in cervical cancer burden. Special emphasis is placed on challenges and opportunities for scaling prevention and care in high-burden, resource-limited settings.
Copyright (c) 2025 Ohoud Ibrahim fallata https://creativecommons.org/licenses/by/4.0
Comprehensive Review of the Success of the Hospital-at-Home Program in Today's Healthcare Delivery
Background: Social prescribing (SP) is a new approach of primary care with the aim of addressing patients' social, emotional, and practical needs (e.g., loneliness and mental health), which traditional medicine is ill-equipped to resolve. Given that 20% of general practice consultations are related to social needs, SP is timely. Aim: To review the implementation of social prescribing (SP) in general practice, including models of delivery, health and wellbeing outcomes, facilitators, barriers, and scalability. Methods: Following PRISMA 2020, we systematically searched MEDLINE, Embase, CINAHL, PsycINFO, and grey literature from 2000 to October 2024. Sixty-eight studies were synthesized narratively using the GRADE approach and thematic analysis, with systematic reviews, primary research, and policy reports included. Results: SP models differ across the globe: the UK is the only country in which the link worker model is formalized, while Canada and Australia have less established approaches. Improved mental health, social connectivity, and reduced food insecurity are associated with SP; evidence for physical health and healthcare use is mixed. Important facilitators include funding and training, while barriers include competing demands on resources and gaps in the evidence base. Conclusions: SP adds strength to general practice by addressing social determinants of health. Standardised evaluation and developing strategies for scalability and equitable access to programs will be important in maximising the impact of SP efforts.
Copyright (c) 2025 Naseabah Ali Mohammed Abu Haddash https://creativecommons.org/licenses/by/4.0
Therapeutic Potential of Plant-Based Dietary Interventions in Chronic Disease Remission: Mechanisms, Clinical Evidence, and Practical Implementation
Background: Chronic diseases such as type 2 diabetes mellitus (T2DM), cardiovascular disease (CVD), hypertension, obesity, and certain cancers represent a large burden of morbidity and mortality worldwide, and many are affected by lifestyle including diet. Unrestricted plant-based diet (PBD), high in whole plant foods and low or no animal foods, has emerging data related to their association with prevention and reversal of chronic disease, including anti-inflammatory, anti-oxidative, and metabolic impact. Aim: To systematically review the evidence for PBD association with remission or substantial improvement in chronic disease, including documenting clinical outcomes, quality of life (QoL), cost-effectiveness, and implementation considerations associated with any PBD. Methods: A literature search was completed from 2000 to 2024 using keywords for plant-based diets, vegetarianism, chronic disease, and other disease-specific keywords. Eligible peer-reviewed studies included adult populations, reported clinical outcomes, QoL, and implementation considerations, with no restrictions on dietary or intervention duration. Study quality was independently assessed with the Cochrane Risk of Bias Tool and Newcastle-Ottawa Scale. Results: Vegan diets produced beneficial clinical outcomes across a range of conditions, including type 2 diabetes (T2DM), cardiovascular disease (CVD), hypertension, obesity, and cancer progression. They improved HbA1c and LDL cholesterol and led to weight loss while preventing or reducing cancer progression. The only challenges, for example, non-adherence and insufficient nutrients, were found. The estimated annual cost savings for the recovery of T2DM and CVD management is $50-100 billion. Conclusion: The evidence shows that PBDs can be effective at managing and possibly inducing remission in chronic diseases, and provide benefits in clinical outcomes, quality of life, and healthcare costs. The barriers to adherence, nutritional deficiencies, and scalability will need to be examined further and require education, infrastructural support, and more research to understand how best to maximize implementation.
Copyright (c) 2025 https://creativecommons.org/licenses/by/4.0
Dark Blood MRI Sequences in Myocardial Tissue Characterization: A Comprehensive Review
Background: Myocardial tissue characterization is crucial in diagnosing and treating cardiovascular diseases (CVDs) such as myocardial infarction (MI), myocarditis, and cardiomyopathies. Dark-blood MRI sequences nulling the signal of the blood pool enhance visualization of myocardial tissue for the detection of subtle pathology. Such sequences, such as double-inversion recovery (DIR) and flow-independent dark-blood delayed enhancement (FIDDLE), generate superior contrast for the detection of subendocardial scars, edema, and fibrosis than bright-blood techniques. Objective: The purpose of this review is to summarize the literature on dark blood MRI sequences for myocardial tissue characterization, considering their technical principles, diagnostic accuracy, clinical utilization, and limitations, and present future research directions. Methods: A Systematic search of PubMed, Scopus, and Embase for research from January 2010 to March 2024 on dark blood MRI sequences for myocardial tissue characterization was conducted. Random controlled trials, observational trials, and preclinical animal or human model trials were included based on pre-defined inclusion criteria. Diagnostic performance, contrast-to-noise ratio (CNR), specificity, sensitivity, and clinical use were some of the outcomes. Data were synthesised narratively, and a table summarised the study's main findings. Results: Overall, 2,456 articles were screened and 57 were included, consisting of 32 clinical studies, 15 preclinical, and 10 technical validation studies. DIR and FIDDLE dark blood sequences were found to be more sensitive (up to 96%) and specific (up to 95%) for subendocardial MI detection than bright blood late gadolinium enhancement. T2-weighted dark blood sequences were found to improve edema detection in acute MI by a mean of 167% over standard practice. Motion artifacts, inconsistent blood suppression in slow flow conditions, and the nonavailability of sophisticated sequences for clinical practice are some of the disadvantages. Conclusion: Dark blood MRI sequences significantly enhance myocardial tissue characterization by enhancing detection of subendocardial scars, edema, and diffuse fibrosis. Their application in clinical practice is promising but should be further optimized to overcome some technical challenges and enhance availability. Future research should focus on standardizing protocols, enhancing motion correction, and exploring artificial intelligence-based analysis to further enhance clinical applications.
Comprehensive Multidisciplinary Management and Long-Term Care Approaches for Newborns with Birth Asphyxia: Clinical Guidelines for Healthcare Professionals
Background: Birth asphyxia is a major contributor to neonatal morbidity and mortality worldwide, frequently resulting in hypoxic–ischemic encephalopathy (HIE) and multi-organ dysfunction. Optimal management requires timely diagnosis, acute intervention, and coordinated multidisciplinary care to minimize adverse outcomes. Aim: To highlight the essential role of multidisciplinary consultations in the clinical management and long-term rehabilitation of newborns affected by birth asphyxia. Methods: This review synthesizes current evidence and clinical guidelines on postnatal consultation strategies for infants with birth asphyxia. The focus is on the integration of neonatology, pediatric subspecialties, and allied health services to ensure comprehensive, individualized care. Literature from peer-reviewed journals and established neonatal protocols was critically analyzed. Results: Effective management necessitates early involvement of a neonatologist for stabilization and ongoing monitoring. Pediatric neurologists provide assessment for neurological injury, particularly HIE. Cardiologists and nephrologists manage cardiac and renal complications, while pulmonologists address respiratory dysfunction. In complex cases with multi-organ involvement, pediatric intensivists or palliative care specialists are essential. Developmental pediatricians, along with physical and occupational therapists, play a crucial role in early rehabilitation and long-term developmental support. Early, coordinated intervention enhances recovery potential and reduces long-term disability. Conclusion: A multidisciplinary consultation framework is critical for optimizing outcomes in birth asphyxia. Early, coordinated, and ongoing involvement of diverse specialties ensures comprehensive management from acute care through long-term follow-up.
Copyright (c) 2025 Abdulaziz saleh ahmad alghamdi, Fatimah Nassir Ahmad Alshrif, MOHAMMED YAHYA SHARAHILI, Fahad Mousa Wasili, SULTAN MOUSA J WASILI, munirah Abdullah ibrahim Namazi, Eman Ahmed Yahya Modawi, MARWA ALI ALKHAWAJA, ABDULLAH YACOUB ALTURKI, TAHANI HUWAYDI ALDHAFEERI https://creativecommons.org/licenses/by/4.0
Pharmacological Role and Clinical Applications of 5α-Reductase Inhibitors-Review Article for Pharmacists and Healthcare Professionals
Background: 5α-reductase inhibitors (5-ARIs), including finasteride and dutasteride, are FDA-approved for treating benign prostatic hyperplasia (BPH) and androgenic alopecia. These agents inhibit the conversion of testosterone to dihydrotestosterone (DHT), reducing prostate volume in BPH and slowing hair loss in androgenic alopecia. Despite their efficacy, concerns regarding adverse effects, such as sexual dysfunction and post-finasteride syndrome, necessitate careful patient selection and monitoring. Aim: This review evaluates the pharmacological mechanisms, clinical applications, and safety profiles of 5-ARIs, providing evidence-based guidance for pharmacists and healthcare professionals. Methods: A comprehensive literature review was conducted, analyzing clinical trials, meta-analyses, and guidelines on 5-ARI use in BPH, androgenic alopecia, and off-label indications. Results: 5-ARIs significantly improve urinary symptoms in BPH (reducing prostate volume by ~25%) and stabilize hair loss in 88% of alopecia patients. Dutasteride offers broader DHT suppression but clinical efficacy similar to finasteride. Adverse effects include sexual dysfunction (e.g., erectile dysfunction, reduced libido) and gynecomastia. Off-label uses (e.g., hirsutism, bladder cancer prevention) show promise but require further validation. Conclusion: 5-ARIs are cornerstone therapies for BPH and androgenic alopecia, though their use demands individualized risk-benefit assessment. Multidisciplinary collaboration ensures optimal outcomes.
Copyright (c) 2025 Saud Alhabeeb, Abdullah Abdulaziz Almetrek , Marwan Ibraheem Al-Amri, Ali Abdulrahman Ali Alajlan, Fahad Abdullah Saleh Alfehaid , ‪Mohanad Khaled Ibrahim Alsaudi, Abdullah Abdulaziz Abdulrahman Alsheeb https://creativecommons.org/licenses/by/4.0
Personalized Approaches to Pharmacotherapy and Physiotherapy in Obstetric Treatment: Improving Medication Safety and Physical Wellness for Pregnant Women
Individualized pharmacology and physical therapy are two areas that have the potential to revolutionize obstetric care, providing evidence-based therapies that will have improved maternal and fetal health outcomes. Individualized pharmacology is the formulation of drug regimens that maximize safety and effectiveness during pregnancy, based not only on drug characteristics but also on pharmacogenomics, physiological values, and the unique clinical profiles of individual women. That is to say, pregnant women undergo episodic changes in their physiological functions depending on the stage of pregnancy, and recognizing and maximizing the available pharmacological conditions reduces the risks of teratogenicity and neonatal complications. Physical therapy can have similar benefits targeting generalized musculoskeletal pains, such as pelvic girdle pain and low back pain, while also optimizing mobility to prevent other complications, including gestational diabetes and preeclampsia. Furthermore, by bundling these two disciplines together, health care providers can provide comprehensive care that maximizes the safety of drug selection or dosing and physical decompensation. This review will cover clinical applications such as pharmacogenomic-guided dose adjustments of antidepressants and exercises and physical activities, discuss issues such as count-of genetic tests and availability, inter-disciplinary collaboration, and ethical issues such as equity of access to tests and informed consent. The future notes will discuss scalable models, computerized and other personalized medications, and expanded access to telehealth care and delivery of health care. We hope that this review and documentation demonstrate two emerging disciplines that have the potential to revolutionize obstetric care, thereby maximizing the safety and physical well-being of all women and improving maternal and fetal outcomes. drug safety, perinatal care, personalized pharmacotherapy, physical therapy, health of women
Copyright (c) 2025 Fahad Mousa Mohsen Maashi, Azhar Mohammed Jaber Alfaifi, ‪Hatem Mosa Maeshi, Ismail Mohammed Hassan Alfaifi, Afnan Mousa M Maashi, Fatimah Hadi Alfaifi, Majid Mosa Muhsin Maeshi, Khaled Mossa Mohsen Mashi https://creativecommons.org/licenses/by/4.0
Strengthening Postpartum Depression Screening and Treatment within Primary Healthcare Centers in Riyadh 1st Cluster
Postpartum depression (PPD) is a mental health issue impacting 10-20% of women worldwide and has far-reaching consequences on both child and maternal health. Despite these far-reaching consequences, PPD incidences are often underdiagnosed and undertreated in primary healthcare, including in the primary healthcare centers (PHCs) of Riyadh 1st Cluster, increasing systemic health burden and limiting timely detection and treatment. This systematic review appraises several peer-reviewed articles published between 2000-2023 and synthesizes research on awareness, screening rates, barriers, and interventions for PPD in primary care, with a focus on adapting findings to the context of Riyadh 1st Cluster PHCs. We report that effective tools for measuring PPD, such as the Edinburgh Postpartum Depression Scale (EPDS), are underutilized due to cultural stigma, limited provider training, and resource constraints within Riyadh’s PHCs. Key barriers identified include cultural stigma towards mental health in Saudi society, lack of standardized PPD protocols, and incomplete mental health resource integration in the Riyadh 1st Cluster. Evidence suggests routine screening during 6-week postpartum visits, culturally competent provider training, and improved case management workflows (e.g., collaboration between triage, waiting room, and shared charts) are effective. Telehealth and automated telephone assessments also show promise for improving PPD detection and treatment in Riyadh’s PHCs. Policy options, such as mandating PPD screening or enhancing provider reimbursement for integrated care, are proposed to address gaps. Reducing these gaps will mitigate short-term consequences like poor mother-infant bonding and yield long-term economic benefits in Riyadh’s healthcare system.
Copyright (c) 2025 Yahya Omar Hazazi https://creativecommons.org/licenses/by/4.0
Nursing Management and Clinical Outcomes of Aspiration Pneumonia in Intensive Care Units: A Critical Review of Evidence-Based Interventions and Risk Reduction Strategies
Background: Aspiration pneumonia (AP) is a severe pulmonary infection resulting from the inhalation of oropharyngeal or gastric contents, leading to significant morbidity and mortality, particularly in intensive care units (ICUs). Distinguishing AP from aspiration pneumonitis is critical, as their management differs substantially. High-risk populations include elderly, neurologically impaired, and mechanically ventilated patients. Aim: This review evaluates evidence-based nursing and medical interventions for AP management, focusing on prevention, early diagnosis, and treatment strategies to improve clinical outcomes. Methods: A critical review of current literature was conducted (50 scanned, and 14 selected), analyzing risk factors, diagnostic approaches, medical treatments, and nursing interventions for AP. Emphasis was placed on multidisciplinary care, including pharmacological management, swallowing assessments, and respiratory support. Results: Key findings highlight the importance of early antibiotic therapy, with amoxicillin, ampicillin-sulbactam, and respiratory fluoroquinolones as primary treatments. Non-pharmacological strategies, such as swallowing evaluations, dietary modifications, and oral hygiene, significantly reduce AP risk. Nursing interventions, including airway management, positioning, and continuous monitoring, are vital in preventing complications. Conclusion: Effective AP management requires a multidisciplinary approach integrating prompt antibiotic therapy, risk factor modification, and vigilant nursing care. Early recognition and preventive measures can reduce mortality and improve patient outcomes.
Copyright (c) 2025 Abdullah Fehaid Fadhad Alruqi https://creativecommons.org/licenses/by/4.0
Role of Inhaled Therapies in COPD Progression and Exacerbation Prevention: A Critical Review
Background: Chronic Obstructive Pulmonary Disease (COPD) management lacks universal consensus on triple inhaled therapy, comprising a long-acting muscarinic antagonist (LAMA), a long-acting β2-adrenoceptor agonist (LABA), and an inhaled corticosteroid (ICS). Current guidelines, such as GOLD, primarily reserve triple therapy for very severe cases (Group D), while other international guidelines advocate for broader use, including in patients with frequent exacerbations or asthma-COPD overlap syndrome (ACOS). This divergence leads to varied real-world prescribing practices, often driven by clinical empiricism rather than strict phenotypic stratification. Emerging evidence suggests therapeutic advantages in specific subgroups, such as those with ACOS, eosinophilic inflammation, or a history of frequent exacerbations, who may benefit from intensified bronchodilator treatment. Aim: This review aims to critically examine the rationale for triple inhaled therapy in COPD by integrating data from various clinical trials, exploring its clinical effectiveness and safety profiles, and considering future trends in COPD management. Methods: A comprehensive literature review was conducted, synthesizing data from clinical trials investigating the simultaneous use of LAMA, LABA, and ICS. The review focused on the pharmacologic rationale, anti-inflammatory effects, and evidence from key clinical trials, including studies on fixed-dose combinations and novel pharmacological approaches. Safety considerations, particularly regarding pneumonia risk and mortality, were also examined. Results: Triple inhaled therapy demonstrates synergistic bronchodilation and anti-inflammatory effects, particularly beneficial in patients with high exacerbation risk, eosinophilic inflammation, or poor symptom control. Clinical trials show improvements in lung function and reductions in exacerbations, though the universal benefit is debated. ICS withdrawal may be feasible in select patients without compromising exacerbation control. Fixed-dose combinations enhance adherence and convenience. Safety concerns include increased pneumonia risk with ICS, especially fluticasone, and historical mortality signals with tiotropium Respimat®, though large trials have largely allayed these concerns. Novel bifunctional molecules like MABAs and PDE4 inhibitors are emerging, offering potential for improved efficacy and simplified regimens. Conclusion: Triple inhaled therapy is a valuable option for specific COPD phenotypes, emphasizing the need for personalized medicine. Future research should focus on identifying biomarkers for ICS responsiveness and assessing long-term safety. Optimal use depends on robust clinical evidence tailored to diverse patient populations.
Copyright (c) 2025 Ziyad Tariq Alluqman, Hussain Abdullah Almutawah, Aqeelah Ebrahem Emwees https://creativecommons.org/licenses/by/4.0
Technology-Driven Nursing Interventions to Support Telehealth in Cardiac Primary Care
Background: Telehealth incorporation is changing the nursing practice in cardiac primary care; technology-driven nursing interventions are providing innovative ways to improve patient outcomes and patient access to care. Nursing interventions driven by technology, such as remote patient monitoring, virtual consultations, and mHealth applications, are becoming increasingly important in cardiovascular disease management. Aim: This review aims to appraise the effectiveness, challenges, and future considerations for technology-driven nursing interventions in telehealth in the area of cardiac primary care, focusing on patient outcomes, nurse workload, and health equity. Methods: A scoping review was conducted using PubMed, CINAHL, Scopus, and Web of Science. The review included studies published between 2015 and 2025 through peer-reviewed journals. Inclusion criteria included studies utilizing a telehealth intervention with nurse involvement in cardiac primary care that had a qualitative/quantitative method. Data were synthesized thematically and quantitatively, based on the variability of outcomes in each study, which were summarized by patient health, nurses’ efficiency, and system-level. Results: The 50 studies showed telehealth interventions were reported to increase patient adherence (85% of studies), decrease hospital admissions (70% of studies), and increase nurse efficiency (60% of studies), but many studies did identify challenges, including digital literacy (40%) and infrastructure (30%). Secondly, reports on equity-related interventions demonstrated some success with providing healthcare to disadvantaged populations. Conclusion: While through technology-enhanced nursing telehealth intervention characteristics show large improvements in processes regarding cardiac care, a large investment in training, infrastructure, and other elements to address technology gaps may be necessary. Future research efforts should focus on implementing scalable and equitable strategies.
Copyright (c) 2025 Basimah Ahmad Abdu Asiri, Razan Mohammed Almutairi, Rama Mohammed Alfadhel, Nuha Nouh AL hawsawi, Sarah Mohammed Faqeehi, Ebtsam Musaed Alshammari https://creativecommons.org/licenses/by/4.0
The Significance of Routine Abdominal Ultrasound Before Bariatric Surgery
Background: Bariatric surgery is emerging as an absolute treatment for morbid obesity with long-lasting weight loss and comorbidity improvement due to the pandemic of obesity all over the world. Preoperative abdominal ultrasound is generally taken for identification of pathologic features to assist in surgical decision, although there is controversy over its role and clinical utility due to varying guideline practices and the absence of cost-effectiveness studies. Aim: This review estimates the efficacy of routine preoperative abdominal ultrasound for bariatric surgery on its basis of diagnostic yield, influence on surgical planning, cost-utility, and its ability to decrease perioperative complications as criteria. Methods: A Systematic literature review was conducted on PubMed, Embase, and Cochrane Library from January 2000 to April 2024 according to PRISMA guidelines. Studies in patients with BMI ≥30 kg/m² with primary bariatric surgery were taken into account. Extracts regarding data of ultrasound results, modification of surgical plan, and cost-effectiveness were matched, and the quality of studies was evaluated by STROBE and Jadad score. Results: Routine pre-operative ultrasound scanning will typically detect anomalies, for example, gallstones and fatty liver, but in no more than 7–15% of instances does this change surgical decision. Incidental diagnoses of malignancy are uncommon but important. Results: Technical challenges in grossly obese individuals and cost make routine use impossible, case selection for imaging is a more cost-effective alternative. Conclusion: Routine ultrasound has limited, focused utility in preoperative bariatric assessment. Focusing on usage, within clinical risk factors, would optimize benefit and resource utilization, pending further assessment on cost-effectiveness.
Copyright (c) 2025 Ibrahim Mansour Nasr, Hajar Muwafig F Al Ruweili, Hmoud moutlq Mohammed alotaibi https://creativecommons.org/licenses/by/4.0
Artificial Intelligence and Robotics in Surgery: The Future of Precision Medicine
Artificial intelligence (AI) and robotics signal a new domain for precision medicine and have fundamentally reformulated surgery into a new disciplinary lens that provides surgical practice with greater accuracy, efficiency, and outcomes. AI-powered systems, such as machine learning algorithms and computer vision, allow for real-time analysis of medical and surgical data, predictive modeling of patient outcomes, and personalization of treatment plans for each patient. In parallel, AI-powered robotic tools, such as the da Vinci Surgical System, offer surgeons a level of precision, control, and cognitive stimulation that rarely equates to manual techniques. This paper will outline the ongoing advancements, challenges, and potential opportunities that AI and robotics have in surgery. Also explored will be the implications for improved patient care relating to minimally invasive procedures, training for surgery, and patient safety. Significant applications of AI and robotics in surgery include autonomous surgical robots, image-guided robotic interventions, and advanced decision-support systems. Collectively, these clinical applications diminish opportunities for human mistakes and improve patient outcomes. However, the broad application of AI and robotics in surgery will depend on acting on ethical questions, regulatory legislation that is forward-thinking, and technical challenges, such as data and image quality, interoperability issues of robotic devices, and surgeon accountability. The challenges that impede the integration of AI and robotics in surgery can be addressed, but a successful practice application equates to future developments that produce the safest, most affordable, and individualized practice of surgery in the world. With the benefits of surgery supported by AI and robots being postulated, there remains a discipline-wide need for research, collaboration, and ethical accountability. This paper will therefore explore the advances of AI and robotics and conclude by emphasizing the importance of research on these approaches to shape the future of precision medicine.
Copyright (c) 2025 SAMI MOHAMMED ALHARBI, Tariq Mohammed al harish, Eman Attyah Zead Alqurashi, Maha Dhuwihi Alsubaie, Njah Mohammad Alanazi , Batool Alhamidi Almutairi, Hadeel Motlaq Almotlaq , HUSSAIN ALI KHABRANI, Sayer Hamdan Salem Alsharari, Tariq Maqbul Awadh Alsharari, Yousef Dhaifallah Dabi Alsharari https://creativecommons.org/licenses/by/4.0
Sustainable Healthcare Practices: Advancing Eco-Friendly Laboratory Management, Integrating Green Initiatives in Nursing Education, and Promoting Value-Based Approaches in General Medicine
Background: The healthcare sector is a significant contributor to environmental damage, with 4.4% of global greenhouse gas emissions from healthcare and large quantities of waste such as single-use plastics and biohazardous waste. As the effects of climate change accelerate, health care systems need to implement sustainable health practices that use the least harmful and minimally damaging methods and still provide care for health and well-being. Aim: This review analyzed eco-friendly lab management, green initiatives in nursing education, and value-based general medicine to develop pathways to sustainable health practices in health care. Methods: A systematic review of the literature was completed using PubMed, Google Scholar, and CINAHL Ultimate. Inclusion criteria limited review to studies published within the past decade, from 2015-2025, and all peer-reviewed studies. Search terms included “sustainable health care”, “Eco-friendly lab management”, “nursing education green initiatives”, and “value-based medicine”. Results: Eco-friendly lab management modeled sustainability by reducing energy use by 20-30% and reducing waste by 20-40% using energy-efficient technologies and sustainable procurement. Nursing education modeled sustainability practices, introducing innovation to increase sustainability consciousness up to 35%, and trained nurses were 40% more likely to incorporate the newly introduced green practices into their nursing interventions. Models of value-based care, including telehealth and green-prescribing, improved sustainability and reduced emissions by 7-12%. Conclusions: Interdisciplinary collaboration, policy support, and education/processes are required to promote scalable practices for sustainable healthcare. Future research needs to work. Specifically, the research we need to conduct should focus on creating cost-effective technologies and emphasizing cross-culturally applicable technologies. Keywords: eco-friendly laboratories, sustainable healthcare, value-based care, nursing education, environmental sustainability.
Copyright (c) 2025 Reem magbol wali magfori, Rawan hussain ahmed makki, Abdulaziz Abdullah Abdulaziz Bin Mohize, Abdulhakeem Mohammed Ahmed Alsalem, Ali Hosain Bojbara, khalid Dhewaihi almutairi, Fahad Saeed Ahmed Alqahtani, Huda Awad Mohammed Aljabri, MOHAMMED SALEM ALMOTAIRI, Asael muhmmed alhazmi https://creativecommons.org/licenses/by/4.0
Integrative Nursing Interventions: A Critical Review of Mindfulness, Aromatherapy, and Therapeutic Touch in Holistic Patient Care
Background: Holistic nursing, grounded in the philosophy of treating the entire person, encompasses physical, emotional, psychological, and spiritual care to enhance the overall well-being of both the patient and the nurse. Holistic nursing approaches, such as mindfulness, aromatherapy, and therapeutic touch, have been increasingly implemented in nursing to respond to the problems of stress, pain, and emotional and psychological distress and are part of a worldwide trend toward more integrative approaches to care. Aim: To review and synthesize the current evidence for efficacy, mechanisms, application, and limitations regarding mindfulness, aromatherapy, and therapeutic touch in nursing. Methods: A narrative review was conducted using PubMed, CINAHL, PsycINFO, and Scopus, with keywords that included "holistic nursing" and "mindfulness efficacy." The quality of each study and all types of evidence was appraised with Joanna Briggs Institute tools with an emphasis on systematic reviews, meta-analyses, and RCTs. Results: Mindfulness was found to have positive and significant effects on reducing anxiety and stress and decreasing burnout (g=0.57). Aromatherapy has positive effects on sleep and pain management. Therapeutic touch has a moderate effect on pain management; however, there is limited direct mechanistic evidence. The majority of limitations include the non-standardized interventions and scepticism. Conclusion: This review provided evidence-based support that these approaches support better outcomes for patients and resiliency for nurses. A larger-scale integration of these approaches in practice requires pre-determined and coordinated protocols, and further systematic review methodology will determine their effectiveness in daily healthcare practice. Keywords: Holistic Nursing, Mindfulness, Aromatherapy, Therapeutic Touch, Integrative Care.
Copyright (c) 2025 Mervat Ali A’Mohsen Alharis, Zahrah Sadiq alfaraj, Abdulhadi Jawad Alhelal, Rana Jawad Alojan, Jumanah Nazmi Alsharidi, Tahani Taher Alkhamis, Jamila Taher Mohammed Alkhamis, AISHAH ALI SULIMAN AL YAHYA, Zainab Ali almatawah https://creativecommons.org/licenses/by/4.0
Evaluation of Nurse Education on Biosecurity and Health Emergency Preparedness: A Comprehensive Review
Background: Nurses play a crucial role in health emergencies, such as pandemics, bioterrorism, and natural disasters, but many gaps exist in the biosecurity and emergency preparedness training for nurses around the world - especially for vulnerable communities in low-resourced settings. Aim: This integrative review evaluates the efficacy of nurse education on biosecurity and health emergency preparedness, examining their nature in nurse education, what they measure, what they assess, what issues exist, and how the findings can be used to make evidence-based, relevant changes. Methods: 27 studies from 2015-2025 were synthesized from PubMed, CINAHL, Scopus, Web of Science, and EMBASE with a focus on education modalities, competency domains, and evaluation. Data were analyzed thematically and descriptively using descriptive and inferential statistics, and quality was appraised using the Mixed Methods Appraisal Tool. Results: Simulation-based education improved knowledge (10% to 30% improvement), skills (p=0.027), and confidence (70% reported a higher perceived preparedness). Simulation training was a better educational modality than a lecture. Low baseline levels of knowledge were noted (78% with no familiarity with any protocols), which were particularly low for bioterrorism-specific education (15% described potential agents correctly pre-education). The DPET and EPIQ measures were both valid and reliable measures of competencies but did not measure the competence specific to bioterrorism. The missing themes in the findings included an absence of exposure to training, standardization for standards of practice, or competency, with no discussion of mental readiness for emergencies that require equivalent faculty support. Conclusion: Simulation-based education and standardization improve nurse preparedness and readiness, although education relating to bioterrorism scenarios and equipping mental health capacity for nurses is essential prior to a public health emergency.
Copyright (c) 2025 Abeer Gharsan Saeed Alzahrani, Sara Ahmed Hashem Alqarni, Rawan Abdullah Saeed Alshehri, Ihdaa Abdulrhman Abdullah Aborreesh, Fahd Mohammed Eid Alian Al Subhi, Nesreen Awad Abdullah Almalki, Asma Hamed Al-Subhi, Elaf Mousa Naji Alsubhi, habib salem mohsen alhuzali https://creativecommons.org/licenses/by/4.0
Precision Pharmacy in Hematology: Integration of Pharmacogenomics into Clinical Decision-Making in Anticoagulant and Chemotherapeutic Agents
Background: Precision pharmacy, driven by pharmacogenomics, personalizes anticoagulant and chemotherapeutic therapy based on the genetic profile of the patient, which enhances the outcome of therapy in hematologic diseases. Aim: This review attempts to address the integration of pharmacogenomics into decision-making regarding anticoagulants and chemotherapeutics in hematology with special reference to the pharmacist. Methods: Systematic review of literature using PubMed, Scopus, and Web of Science was conducted for studies between the years 2020-2024. Selection criteria focused on pharmacogenomic applications in hematology. Data were integrated to identify key gene-drug interactions, implementation strategies in clinics, and hindrances. Results: Pharmacogenomic testing of CYP2C9/VKORC1 for warfarin dosing reduced bleeding events by 15%, while TPMT/NUDT15 testing for thiopurines reduced myelosuppression by 25%. Clinical decision support systems (CDSS) and proactive testing, like the PHASER program, improved outcomes by 12–18%. Limitations involve cost, availability, and clinician training constraints. Conclusion: Pharmacogenomics improves the safety and efficacy of anticoagulant and chemotherapeutic treatment in hematology, with pharmacists as central implementers. Continued advances in AI and multi-omics will progressively optimize precision pharmacy.
Copyright (c) 2025 Riyad Yahya Thubab, Hafed Mohammed Madkhali, Hassan Omar Assiri https://creativecommons.org/licenses/by/4.0
Impact of Telemedicine and Teleradiology on Interprofessional Collaborative Care Among Nurses, Pharmacists, and Radiologists: A Systematic Review
Background: Telemedicine and teleradiology have revolutionized healthcare by enabling the remote delivery of clinical services and diagnostic imaging, thereby enhancing interprofessional collaborative care among nurses, pharmacists, and radiologists. Since 2015, these technologies have gained momentum, particularly with the COVID-19 pandemic, addressing the need for convenient care across different settings. Aim: This review assesses the impact of telemedicine and teleradiology on collaborative care, focusing on patient outcomes, healthcare efficiency, and interprofessional relationships. Methods: A systematic narrative review was conducted, searching PubMed, Scopus, Web of Science, and CINAHL for peer-reviewed articles (2015–2025). Keywords were "telemedicine," "teleradiology," and "collaborative care." Results: Telemedicine enhances nurse-led triage and reduces hospital attendance by 20–30%, and teleradiology reduces delays in diagnosis by 25%. Telepharmacy increases adherence by 10–15%. The barriers are technological, regulatory, and role ambiguity. Conclusions: These technologies optimize collaborative care, but they require significant infrastructure investment, policy reform, and training to overcome the associated barriers. Future research should focus on developing standardized protocols and integrating AI
Copyright (c) 2025 Mazen Abdullah Mohammed Alqarni, Fahd Mohammed Alharbi, Ahmad Yahya Ali Daghriri, Mosa Hussien Jordi Tohari, Moataz Ahmed Mohammed Awaji, Ali Hasan Ali Gharawi, Ibrahim Saad Altukhais, Ahmed Mohammed Nasser Amri, Fatimah Suwaylih Almutairi, Fatima Galeb Ali Alanbari, Meshal Nashi Ayad Alshaibani https://creativecommons.org/licenses/by/4.0
Review Study: Education and Training Requirements for Laboratory Medicine Nurses in General and Emergency Settings
Background: Nurses have a pivotal role in implementing laboratory medicine in clinical practice, requiring proficiency in interpreting diagnostic results, particularly in stressed emergency settings. Developments in healthcare technology between 2015 and 2025 have increased such needs, but training gaps persist. Aim: The review establishes training and educational needs for laboratory medicine nurses in general and emergency environments, including evidence-based recommendations. Methods: A systematic review using PubMed, CINAHL, and Cochrane Library was conducted, with qualitative and quantitative methods. Thematic synthesis and descriptive analysis were used, with quality established using the Johns Hopkins Levels of Evidence. Results: The main findings highlight gaps in nurses' preparedness for laboratory medicine activities, especially in the emergency setting. CPD, simulation-based education, evidence-based practice (EBP), and interprofessional education are priorities but are underpinned by cessation of funding, time constraints, and non-standardized curricula. Emergency nurses require specialized training in practical testing and rapid diagnostics. Conclusion: Improved and standardized training courses, increased funding for CPD, and interprofessional education are required to equip nurses with laboratory medicine demands to optimize patient outcomes.
Copyright (c) 2025 Amirah Fawaz Alwadani, Ahmed Abdullah Faris Alotaibi, Solaiman Rashed Alfaheed, Yahya Alzahrani, Hussain Homoud Habibi Namazi, Anwar Rashed Ashwa Alanazi, Mashael Huwaydi Aldhafeeri, Bashaier Huwaydi Aldhafeeri, Reham Saleh Saber Al/Raddadi, Hanan Essa Alharbi, Sabah Abdo Mohammed Bakr, Bayan Osama Muhammed Mugharbel https://creativecommons.org/licenses/by/4.0
The Influence of the Clinical Nurse Leader Role on Healthcare Quality: A Narrative Review of Patient Outcomes, Care Coordination, and System-Level Efficacy
Background: Clinical Nurse Leader (CNL), initiated by the American Association of Colleges of Nursing in 2004, is a master-prepared role developed to enhance patient outcomes and microsystem-level care coordination in opposition to growing complexity in healthcare. Aim: This narrative review synthesizes evidence regarding the influence of the CNL on patient safety, quality, satisfaction, readmission, and care coordination, with challenges and future directions. Methods: A Systematic review of various studies in PubMed, CINAHL, and Scopus was conducted, synthesizing quantitative and qualitative information. Two tables summarize CNL interventions and outcomes. Results: CNLs reduced hospital-acquired infection (e.g., 20–40% reduction in CAUTIs), improved chronic disease management (5–10% reduction in HbA1c), enhanced patient satisfaction (10–15%), and reduced 30-day readmissions (10–25%). They enhanced interdisciplinary collaboration (15–20% improved communication) and optimized use of resources (10–15% shorter waits). Barriers are role ambiguity and uneven measures, for which there is sparse international evidence. Conclusions: CNLs have a substantial positive impact on patient outcomes and care coordination and align with healthcare reform objectives. Normalized measures, longitudinal data, and international studies are necessary to extend their influence, especially in underserved areas.
Copyright (c) 2025 Hawraa Abdulhadi Haashim Alsadah, Nouf nasser abdulaziz almulhim, Zainab Abdullah Alburayh, Fatimah Yousef Abdullah Alobud, Sawsan Hussain Mohammed Alawad, Rawan fahad abdultif alzuwayyid, Rawan abdulrahman al marzooq, Asala Hamdan Alruwaili, FATIMAH YASSEN ABDULLAH ALALAWI, HASSAN ALI ABDULLAH ALNAZR https://creativecommons.org/licenses/by/4.0
Enhancing Patient Outcomes in Orthopedic Clinics: The Interdisciplinary Role of Nurses, Physiotherapists, and Medical Secretaries-Pelvic Fracture as a Model
Background: Pelvic fractures are complex injuries with high risks of hemorrhage, multisystem involvement, and long-term disability. Optimal outcomes depend on coordinated, interdisciplinary care, particularly from nurses, physiotherapists, and medical secretaries, across the continuum from resuscitation to rehabilitation. Aim: To synthesize role-specific contributions of nurses, physiotherapists, and medical secretaries in orthopedic clinics, using pelvic fracture care as an archetype, and to map these contributions to measurable patient and service outcomes. Methods: Narrative synthesis of current clinical pathways for pelvic fracture evaluation, stabilization, and rehabilitation; role delineation across care phases (prehospital, emergency, operative, inpatient, rehabilitation, and post-discharge); and identification of outcome domains influenced by each profession. Results: Nurses drive hemodynamic surveillance, hemorrhage mitigation, early complication detection, patient/family education, and coordination of trauma protocols; physiotherapists deliver staged mobilization, gait training, pelvic floor and core rehabilitation, and functional capacity rebuilding; medical secretaries enable continuity through scheduling, information flow, documentation integrity, benefits navigation, and inter-service logistics. Interdisciplinary alignment is associated with reduced time-to-stabilization, fewer preventable complications, shorter length of stay, earlier mobilization, improved functional scores, and higher patient satisfaction. Conclusion: In pelvic fracture care, integrating nursing vigilance, physiotherapy-led functional recovery, and medical-secretarial coordination yields superior clinical and operational outcomes. Formalizing shared pathways, handoffs, and metrics should be a strategic priority for orthopedic services.
Copyright (c) 2025 Muneera Hassan Albuaijan, Hoor Jawad AlQasim, khaled lafi jazi Al-Balawi, Mohammed Salem ALMOTAIRI, Tasneem Hejje ALKHAIBARI, Sahar Rubayyi Albalawi, Awadh Saleh Alamri, Nawal Jadaan Almotairi, Aljawharah Ali Alabsi, Meshal Nashi Ayad Alshaibani, Bayan Osama Muhammed Mugharbel https://creativecommons.org/licenses/by/4.0
Lumbar Spinal Stenosis: Multidisciplinary Care Pathway for Radiology, Nursing & Physical Therapy
Background: Lumbar spinal stenosis (LSS) is a leading cause of pain, gait limitation, and surgery in older adults. Because symptoms reflect both fixed anatomic narrowing and posture-dependent dynamics, single-modality decisions underperform. Aim: To outline a multidisciplinary care pathway integrating radiology, nursing, and physical therapy (PT) to improve diagnostic accuracy, functional outcomes, and value. Methods: Narrative synthesis of core domains—anatomy, etiology, epidemiology, pathophysiology, history/physical, evaluation, treatment, prognosis, complications, patient education, and team operations—emphasizing actionable links between imaging phenotypes (central, lateral recess, foraminal, extraforaminal) and bedside/rehabilitation decisions. Results: Flexion widens canal/foramina; extension worsens crowding—an insight that aligns patient education and PT toward flexion-biased programs. MRI remains first-line; axial-loading MRI and CT/myelography resolve discrepancies or contraindications. Standardized MRI grading (e.g., Schizas/Chen Jia/Lee) plus functional metrics (SPWT, ODI) enable decision-ready reports. Epidural injections provide short-term relief with modest effects on walking; medial branch radiofrequency helps facet-predominant pain. When needed, decompression—open, minimally invasive, or endoscopic—improves pain and function; fusion is reserved for instability/deformity. Interspinous spacers benefit selected extension-sensitive, one-to-two-level disease without osteoporosis/instability. Conclusion: A pathway that matches mechanism to modality—precise radiology, nurse-led safety/education, and PT-led graded conditioning—yields faster, safer diagnosis and individualized care, limiting unnecessary procedures while preserving surgical benefit for appropriate candidates.
Copyright (c) 2025 Ghazy Hassan Mohajer, Amnah Abdu Khormi, Wael Atiah Safhi, Ali Majed Mohammed Malhan, Atheer Ibrahim Hadi Matabi, Mansor Ali Ahmad Alsbee, Mohammed Salem Almotairi, Abdulelah Hassan Alhathiq, Abdullah Ahmed Rayyani, Khaled Mohammed Ogdi, Abdulaziz Mohammed Yahya Moafa https://creativecommons.org/licenses/by/4.0
Cracked Tooth Syndrome: Clinical Diagnosis, Nursing Care, and Laboratory Considerations.
Background: Cracked tooth syndrome (CTS) is a prevalent, diagnostically challenging condition with heterogeneous symptoms and variable progression that can compromise pulpal and periodontal health. Aim: To synthesize contemporary clinical guidance on CTS encompassing diagnosis, nursing care, and laboratory considerations to inform patient-centered, team-based management. Methods: Narrative integration of clinical history/physical examination features, adjunctive diagnostic tools (magnification, fibreoptic transillumination, bite tests, vitality testing, radiography/CBCT), etiologic and epidemiologic determinants, treatment pathways from conservative stabilization to endodontic therapy or extraction, and interprofessional roles. Results: Early, structured evaluation improves localization and staging of cracks and enables timely stabilization. Direct bonded restorations and provisional external splinting relieve symptoms and reduce flexure; definitive cuspal coverage redistributes occlusal forces. Pulpal involvement or root extension worsens prognosis and may necessitate endodontic treatment with guarded long-term survival or extraction. Nurses augment outcomes through triage, education, and adherence support; laboratories optimize material selection, digital design, and splinting biomechanics. Conclusion: CTS outcomes improve when clinicians pair rigorous diagnostics with staged biomechanical control and clear expectation-setting, supported by coordinated nursing and laboratory contributions. Early detection remains the pivotal determinant of tooth preservation.
Copyright (c) 2025 Yousef Mohammad Gh Almutairi, Noura Jaber Al-Asmari, Hanan Zaal R ALruwaili, Huda Daifallah Al Saadi, Mohammed Almutairi, Khalid Fahd Ali ALRushaidan, Abdulaziz Fouad Abdulqader ALNoman, Asala Hamdan Alruwaili, Fatimah Mohammed Eisa Alabbad, Saleh Mohammed Alghamdi, Norah Nasser Saleh Al Yami, Hamad Mohaimeed Hamad Alotaibi, Meshal Saleh Alenazi https://creativecommons.org/licenses/by/4.0
Utilization of Video Conferencing for Paramedic-to-Physician Consultations in Pre-Hospital Emergency Care: A Comprehensive Review
Background: Pre-hospital emergency care is critical for the handling of acute conditions such as stroke, ST-elevation myocardial infarction (STEMI), and trauma, where timely interventions are life-determining. Video conferencing allows real-time paramedic-to-physician consultations, enhancing decision-making and patient outcomes. Aim: The aim of this review is to evaluate the application of video conferencing in pre-hospital EMS, in terms of the technological requirements, legal issues, and impact on pre-hospital care and ED preparedness. Methods: A narrative review of peer-reviewed literature from 2015 to 2025 was undertaken via PubMed, Scopus, and CINAHL. Keywords were "video conferencing," "telemedicine," "paramedic," and condition-specific terms. Results: Video conferencing improves diagnostic accuracy (e.g., 20% for stroke), treatment adherence (15% increase), and patient outcomes (e.g., 25-minute reduction in stroke door-to-needle time). It improves ED readiness by facilitating communication streamlining, resource allocation (30% reduction in STEMI wait times), and triage efficiency. Challenges include rural connectivity issues, training needs, and legal uncertainties. Conclusion: Video conferencing transforms EMS because it enhances care provision and ED preparedness but requires robust technology, clear regulations, and training. Connectivity and AI incorporation are aspects to be prioritized for future research.
Copyright (c) 2025 Majed Azmi Ghanem Aldahmashi, Ysif Saleh A alhazmi, Rizgallah Farj A Alrawili, Hamoud Hajji A Aldahmashi, Mohammed Mrih M Alenezi, Abdulaziz Basheer Shami Alanazi, Sami Jumah Khatam Alhazmi, Mohammed Qaem Essa Alanazi, Muteb Batel Nawman Alhazemi, Abdulaziz Moraya Binyah Alanazi, Sami Alamlah Shatah Alanazi, Aabdullah aladham Alenezi, Basim Mousa Alhumaidi Alhazmi, Ayed Salhoub A Alswilmi, Nawaf Rasheed sunaydih Alruwaili, Amad Lafi S Alenezi https://creativecommons.org/licenses/by/4.0/
Multidisciplinary Management of Depression in Patients with Chronic Illness: Integrating Psychological, Nutritional, Nursing, and Digital Health Approaches
Background: Major Depressive Disorder (MDD) is a highly prevalent condition that frequently co-occurs with chronic medical illnesses, creating a synergistic burden that worsens quality of life, impairs treatment adherence, and increases mortality. The relationship is bidirectional, with medical illness increasing depression risk and depression contributing to the onset and progression of somatic disease. Aim: This article aims to review the multidisciplinary management of depression in medically ill patients, integrating psychological, pharmacological, nursing, social, and digital health approaches to improve detection and treatment outcomes. Methods: The review synthesizes epidemiological data, pathophysiological mechanisms (including shared genetics, inflammation, and neurobiological pathways), and evidence from clinical trials and meta-analyses. It evaluates diagnostic challenges, screening tools, and a range of management strategies, including pharmacotherapy (with attention to drug-disease interactions), psychotherapy, neuromodulation, and collaborative care models. Results: Depression is prevalent across chronic conditions like cancer, cardiovascular disease, and diabetes, with rates often exceeding 20%. Effective management requires an integrated, etiology-driven approach. Antidepressants and adapted psychotherapies demonstrate efficacy, but success depends on careful agent selection to avoid adverse interactions. Collaborative care models, which systematize screening and combine a care manager with psychiatric oversight, consistently yield the best functional and symptomatic outcomes. Conclusion: A multifaceted, patient-centered strategy that coordinates medical and mental healthcare is essential. Success hinges on moving beyond simple screening to embed management within a structured, multidisciplinary framework that addresses the complex biological, psychological, and social interplay between depression and physical illness.
Copyright (c) 2025 Aiman Ali Ebrahem Shehab, Abdulrahman Ahmed Mohammed Moafa, Mohammed Othman Ibrahim Kamili, Alaaldeen Ahmed Ibrahim Shehab, Mohammed Ahmed M Moafa, Ibrahim Mohammed Ali Muallim, Khalid Mohammed Ali Sahli, Nasser Mohsen Nasser Aljafery, Anwar Ali Hakami, Akram Abdulkarim Al-Juhani, Fahad Ali Mohammad Sweidi, Adel Mohammed Mousa Hamzi https://creativecommons.org/licenses/by/4.0/
Clinical Management and Pharmacological Support in Surgical Extraction of Unerupted Teeth: An Updated Review for Dentists, Pharmacists, Laboratory Workers.
Background: The extraction of unerupted and impacted teeth is a common yet complex surgical procedure in dentistry. These teeth, which fail to erupt into the dental arch, can lead to pathologies such as cysts, infections, and damage to adjacent structures, necessitating careful surgical management. Aim: This review aims to provide an updated, comprehensive guide for dental professionals on the clinical management and pharmacological support for the surgical extraction of unerupted teeth, emphasizing a multidisciplinary approach to optimize patient outcomes. Methods: The article synthesizes current evidence on diagnosis, classification (utilizing systems like Pell and Gregory and Winter), and surgical techniques. It details the roles of pre-operative assessment, including advanced imaging like Cone Beam Computed Tomography (CBCT) for risk stratification, and outlines the step-by-step surgical protocol from flap design to socket management. Results: Successful outcomes depend on meticulous planning and execution. Key findings highlight the importance of CBCT in assessing proximity to neurovascular bundles, the efficacy of techniques like tooth sectioning and coronectomy in reducing complications, and the critical need for tailored pharmacological management for pain, infection, and bleeding control. Complications such as alveolar osteitis, nerve injury, and oroantral communication are discussed with evidence-based prevention and management strategies. Conclusion: The surgical extraction of unerupted teeth requires a systematic, team-based approach. Integrating precise surgical techniques with appropriate pharmacological support and interdisciplinary collaboration among dentists, pharmacists, and laboratory workers is essential for minimizing risks and ensuring patient safety and effective recovery.
Copyright (c) 2025 Mai Abdullah M Alqunfdi, Hanan Muntaha Hassan Al-Moashi, Zohour Abduqader Baamer, Khdigah Mansour Sarhan, Mohammed Almutairi, Ali Mohammed Qassim Hazzazi, Amal Ahmad Ali Hardi, Fatimah Saad Alotaibi, Hanan Awad Awaad Alosaimi, zaki yahya bawkar hawbani, Abdullah Rashid Alharbi, Reem Mohammad alhumaidan, Mohammed Othma AlRethy, Dawla Ali Al aqili https://creativecommons.org/licenses/by/4.0
Interdisciplinary Perspectives on Opioid Toxicity: Nursing, Medical, and Health Security Dimensions
Background: Opioid toxicity represents a critical public health crisis, characterized by a sharp rise in misuse, addiction, and fatal overdoses. This complex issue stems from the pharmacological effects of opioids on the central nervous system, particularly respiratory depression, and is fueled by a combination of prescribing practices, patient vulnerabilities, and social determinants. Aim: This review aims to synthesize interdisciplinary perspectives on opioid toxicity, focusing on the integrated roles of nursing, medical management, and health security in prevention, acute intervention, and long-term harm reduction. Methods: The analysis is based on a comprehensive review of clinical practices, including patient assessment, diagnostic criteria, and treatment protocols. It evaluates medical management strategies like Medication-Assisted Treatment (MAT) and nursing interventions for acute toxicity and monitoring. Health security dimensions, such as prescription drug monitoring programs and secure storage, are also examined. Results: Effective management requires a coordinated, multi-pronged approach. Key findings highlight the efficacy of naloxone for overdose reversal, the central role of MAT (e.g., buprenorphine, methadone) in treating Opioid Use Disorder (OUD), and the critical importance of nursing in continuous monitoring, patient education, and risk assessment. Health security measures are essential for preventing diversion. Conclusion: Combating the opioid epidemic necessitates a unified strategy that bridges clinical care and public health. Interprofessional collaboration among nurses, physicians, pharmacists, and health security professionals is paramount to ensuring safe prescribing, effective overdose response, and sustainable recovery, thereby reducing morbidity and mortality.
Copyright (c) 2025 Faten Aden Almutairi, Mona Saleh Almutairi, Nouf Saleh Almutairi, Ahlam Ahmed Abdu Masrahi, Zahra Ibrahim Bohis Tohary, Ameerah Ali Ibrahim Somali, Asrar Hassan Yahya Daghriri, Shaima Ahmed Daghriry, Eman Ali Jassim Alsafwani, Aisha abdow hadadi, Noura Jaber Al-Asmari, Kathiyh Jaman Alyami https://creativecommons.org/licenses/by/4.0
Evaluating the Cost-Effectiveness and Long-Term Impact of Community-Based First Aid (CBFA) Programs: A Comprehensive Review
Background: Community-Based First Aid (CBFA) programs educate laypeople to respond to emergencies, addressing pressing gaps in pre-hospital care, particularly in resource-scarce settings. Their cost-effectiveness and long-term impact are under-researched despite growing adoption globally. Aim: This review evaluates the cost-effectiveness and enduring impact of CBFA programs, identifying barriers and facilitators to inform scalable implementation approaches. Methods: Peer-reviewed studies (2000-2025) from PubMed, Scopus, Web of Science, and grey literature were synthesized narratively. Inclusion criteria were peer-reviewed and grey literature that reported on CBFA effectiveness, costs, or long-term outcomes in any setting. Data were extracted for study design, population, interventions, and outcomes (e.g., ICERs, skill retention), and quality was assessed using GRADE and Cochrane tools. Results: CBFA programs are very cost-effective, with ICERs < $500/QALY and benefit-cost ratios as high as 4.2:1. Long-term studies report sustained benefits, including 20-25% reductions in injury hospitalizations and 15-20% improvements in helping behaviors up to 3 years post-training. Challenges: skill decay (20-30% within 6-12 months) and limited funding. Electronic resources and CHW integration support scalability. Conclusion: CBFA programs are a cost-effective, equitable emergency preparedness intervention, supporting SDG 3. Policymakers need to prioritize digital integration and strict evaluations for maximal effect.
Copyright (c) 2025 Yasir Hadi Falah Alanazi, Meshal Juayf Abdullah Alanazi, Mohammad Tabshan Nogaimsh Alsharare, Ali Ayash Tala Al-Hazmi, Abdullah Jeza Awaed Al Enazi, Bader Khaled Salem ALrayes, Khaled Fayez Zaal Alanazi, Anwar Rashed A Alanazi https://creativecommons.org/licenses/by/4.0
A Systematic Review of Patient Complexity and Clinical Protocols: Acute-on-Chronic Multi-Morbidity Management in the Emergency Department
Background: The 21st-century Emergency Department (ED) is faced with a rising number of patients with complex multi-morbidity (CMM) presenting with acute deteriorations, or "acute-on-chronic" illness. These patients have intricate interactions between chronic diseases, polypharmacy, cognitive impairment, and social vulnerability that frustrate traditional single-organ emergency care and lead to diagnostic uncertainty, iatrogenic harm, and poor outcomes. Aim: The aim of this review was to summarize the literature on acute-on-chronic CMM in the ED and present the argument for the need to develop specialized, interdisciplinary protocols for physicians and nurses to improve care for this vulnerable population. Methods: A narrative synthesis of the literature was conducted. The review analyzed the nature of CMM patients, critiqued existing care models like Geriatric ED guidelines, and proposed new protocol elements. Two new conceptual tools were developed: a nursing assessment framework and a formal communication tool for transitions in care. Results: The comparison confirmed the presence of a mismatch between CMM patient needs and usual ED functioning. While models like GEDA provide a foundation, a more comprehensive, protocol-based solution is required. The review prompted the creation of two helpful tools: a protocol for a thorough nursing assessment (covering cognition, function, and social context) and a standard handoff tool for ensuring safe transitions to primary care. Conclusion: A paradigm shift toward proactive, holistic, protocol-driven care is required for acute-on-chronic CMM patients. Specialized interprofessional protocols are fundamental to advancing patient safety and promoting sustainable emergency care. Future research must focus on the validation of complexity screening tools and the evaluation of the impact of these protocols on patient-centered outcomes.
Copyright (c) 2025 Abdulmajeed Obaid Alanazi, Saleh Ashway Nahar Alshammari, A Majed Farhan Awad Al-Hazmi, Owaed Awad Alhazmi, Amer Mudhhi Suayn Alhazmi, Tahani Hakami, Hanen Ibrahim Safar, Yusif Husin Al Enazi, Ayman Mohammed Altayyari, Bandar Saleem Alharbi, Nabeel Albalawe, Khaled Fayez Zaal Alanazi https://creativecommons.org/licenses/by/4.0
The Pharmacist's Role in CAR-T Cell Therapy: From Protocol Development to Toxicity Reduction
Background: CAR-T cell therapy is cutting-edge immunotherapy for hematologic malignancies, and the pharmacist has a crucial role to play in its safe delivery. Aim: Through this review, the pharmacist's role in CAR-T therapy, ranging from protocol development to toxicity management, is evaluated with consideration of real-world evidence and the future direction. Methods: A Systematic literature review was conducted on PubMed, Embase, and Web of Science using searches for studies between 2017–2025. Relevance to pharmacist roles in CAR-T therapy informed study selection, synthesizing data on protocol management, product handling, and toxicity mitigation. Results: Pharmacists enable regulatory compliance, manage product logistics, and guide toxicity interventions, reducing adverse events by up to 40% in some settings. Case studies illustrate outpatient care (85% ambulatory care) and tocilizumab early start (90% severe CRS prevention). Complications are supply chain interruption and limited specialist roles (20% of centers). Conclusion: Pharmacists are the key to the success of CAR-T therapy, improving safety and outcomes. Dedicated positions and standardized training would be necessary to cope with emerging challenges, especially in outpatient and solid tumor settings.
Copyright (c) 2025 Abdulrahman Atiah Alghamdi, Naif Ali Almalki, Fahad Mosakin Althubyani, Saleh Awadh Alshamrani, Manal Abdulaziz Alsharif, Eisi Menwer Alamri https://creativecommons.org/licenses/by/4.0
The Interface of Nutrition and Immunity: An in-depth look at nutritional interventions for the oncology patient receiving immunotherapy
Background: Immunotherapy, as immune checkpoint inhibitors (ICIs), has revolutionized oncology by taking advantage of the patient's native immune system to combat cancer. Although responses are heterogeneous, immune-related adverse events (irAEs) can limit treatment benefit and decrease quality of life. A growing appreciation is arising that host factors, including nutritional status and diet, play an important role in determining the immune response and tumor microenvironment. Aim: The objective of this review is to provide an overview of the current evidence relating to nutritional strategies in cancer immunotherapy patients. It considers the ruinous role of malnutrition (cachexia) in clinical outcomes, reviews the mechanisms by which particular dietary components influence anti-tumor immunity and treatment side effects, and provides a model for the practical assessment and management of nutritional deficits. Methods: A systematic review of the literature was conducted through the utilization of leading scientific databases (e.g., PubMed, Scopus, Web of Science) to identify preclinical, clinical, and review articles published up to 2024. Search terms were permutations of "immunotherapy," "immune checkpoint inhibitors," "nutrition," "diet," "cachexia," "microbiome," and "immune-related adverse events." The evidence was synthesized to provide a narrative review of the existing literature. Results: There is evidence that indicates that sarcopenia and malnutrition have a close correlation with poorer efficacy of ICI and increased toxicity. Individual nutritional interventions are promising for modulating outcomes: adequate consumption of good-quality protein is crucial for the avoidance of muscle wasting and immune function maintenance; dietary fiber and omega-3 fatty acids exert anti-inflammatory effects and preserve a healthy gut microbiome; the Mediterranean diet and vegetarian dietary patterns are related to improved survival; and micronutrients like Vitamin D have a role in immune regulation. The gut microbiome is identified as a mediator between diet and immunotherapy response. Conclusion: An active, individualized nutrition approach, emphasizing a whole-food, plant-based diet, adequate protein, specific micronutrients, and gut microbiome support, is very promising as an adjunctive strategy to enhance the efficacy and tolerability of immunotherapy. Further robust, prospective clinical trials are needed to solidify specific recommendations and integrate nutritional therapy into the standard armamentarium of immuno-oncology treatment.
Copyright (c) 2025 Afaf Snitan Al-Otaibi, Reem Salem Alharbi, Nasra Jamaan Alanizi, Ohood Alhameedy Alanizi, Asma Fahad Alotaibi, Wejdan Abdulrahman Alshehri, Reham Mohammad Alsoulaimi, Muteb Nasser Alotabi, Fayiz Khalaf Alanazi, Majed khalid Aljarallah, Salma Ali khrami, Khulud Nayyaf Alotaibi, Manar Obaid Alanazi, Majed Battah Alshammari, Turki Saleh Alduhaim, Fahad Mohamed Alanazi, Jaber Ali Hassan Alshehri https://creativecommons.org/licenses/by/4.0
De-implementation in Nursing: A Systematic Review of Strategies to Stop Low-Value Care to Improve Patient Safety and Workload Reduction
Background: Continued delivery of low-value nursing care—practices outdated, ineffective, or even harmful—compromises patient safety and contributes to unnecessary nursing workload. While the new implementation of evidence is the focus, the systematic process of removing such practices, known as de-implementation, is needed for healthcare quality improvement. Aim: The aim of this review study is to synthesize current evidence on de-implementation in nursing, present its theoretical basis, enumerate typical low-value practices, and identify effective ways to stop them for improved patient outcomes and optimal workflow in nursing. Methods: An integrated literature review was conducted by combining results from current empirical studies, systematic reviews, and quality improvement reports on de-implementation and low-value care in nursing and interprofessional settings. Results: Routine Foley catheterization, unnecessary vital sign monitoring, and liberal physical restraint use are strong de-implementation candidates, the review implies. Successful strategies are multifaceted, including audit and feedback, clinical decision support in electronic health records, nurse-initiated protocols, and sending out professional campaigns like Choosing Wisely. Success is highly dependent on strong clinical leadership, a psychological safety culture, and interprofessional collaboration to counter cognitive inertia and embedded professional norms. Conclusion: De-implementation is an ethical and pragmatic imperative to nursing. Systematically eliminating low-value care is essential to sustain patient safety, reduce iatrogenic harm, and allow nurses to focus their skills on high-value, individualized care
Copyright (c) 2025 Fayza Karman Nasha Al Hazmi, Amani Zaben Mashan Alanazi, ‏Musa Samir Ayesh Al-Rakhimi, Shroq Hadi Hassan Hamzi, Khaled Mohammed Alamri, Abdullah Talaq ALnami , Nada Ahmad Awois, Hussam Ali Mohammed Alasam, Abdulrahman Abdullah Alashjaee, Mohammed Abdulrahman Almutairi https://creativecommons.org/licenses/by/4.0
Integrated Emergency, Nursing, and Family Medicine Approaches to the Recognition and Management of Adrenal Crisis
Background: Adrenal crisis is a life-threatening endocrine emergency caused by a severe deficiency of cortisol, often triggered by physiologic stress in individuals with underlying adrenal insufficiency. Despite being treatable, it carries a significant mortality rate, estimated at 0.5 deaths per 100 patient-years, primarily due to delays in recognition and intervention. Aim: This article aims to outline the integrated, multidisciplinary approach required for the prompt recognition, emergency management, and long-term prevention of adrenal crisis, emphasizing roles across emergency medicine, nursing, and family medicine. Methods: Management is centered on immediate parenteral glucocorticoid administration (100mg hydrocortisone IV/IM) and aggressive fluid resuscitation with isotonic saline. This is coupled with correction of hypoglycemia and electrolyte imbalances. Diagnosis relies on clinical suspicion based on a history of adrenal insufficiency, chronic steroid use, or presentation with refractory hypotension, and is supported by laboratory findings (e.g., hyponatremia, hyperkalemia, hypoglycemia). Results: Prompt treatment leads to rapid clinical improvement, but delayed intervention results in high mortality and complications such as seizures, arrhythmias, and multi-organ failure. Patient education on "sick day rules" (stress-dose steroids) and access to emergency hydrocortisone injection kits are critical for preventing recurrent crises. Conclusion: Adrenal crisis remains a preventable cause of death. Optimal outcomes depend on a high index of suspicion, immediate empiric therapy, and a coordinated interprofessional team strategy to ensure seamless care from emergency response to long-term community management.
Copyright (c) 2025 Badrea Asri Alenazy, Khulud Saleh Ashamlani, Sultan Daaj Alotaibi, Khalid Abdullah Mudaysh Bajawi, Lawahith Mohammad Alhumaidan, Ahmed Saeed Alzahrani, Maryaim Yousef Alshehab, Khalid Mohammed D Aldossari, Zahra Ali Alzahrani, Aeshah Omar Musayyab Almaghrabi, Wejdan Hamed Saghir, Abeer Oudah Alyanbaawi, Rabab Ebrahim Qaboli https://creativecommons.org/licenses/by/4.0
Interdisciplinary Evaluation and Management of Asymptomatic Carotid Artery Stenosis: Pharmacological Optimization, Nursing Care Coordination, and Radiological Diagnostic Integration
Background: Asymptomatic carotid artery stenosis (ACAS), a narrowing of the carotid artery without recent neurological symptoms, is a common manifestation of systemic atherosclerosis and a marker for increased stroke and cardiovascular risk. Its management balances the prevention of future stroke against the risks of intervention. Aim: This review provides an interdisciplinary update on the evaluation and management of ACAS, integrating perspectives from radiological diagnostics, pharmacological optimization, and nursing care coordination to guide evidence-based, patient-centered decision-making. Methods: The synthesis is based on a comprehensive analysis of current guidelines, clinical trials, and cohort studies. It evaluates the roles of various diagnostic imaging modalities (duplex ultrasound, CTA, MRA) for risk stratification and examines the efficacy of best medical therapy (BMT) versus revascularization (CEA, CAS, TCAR). Results: Contemporary BMT, including statins, antiplatelets, and aggressive risk factor control, has significantly reduced the annual ipsilateral stroke risk to approximately 0.9-1%. This diminished baseline risk narrows the net benefit of routine revascularization. Current management therefore prioritizes BMT for most patients, reserving intervention for those with high-risk features such as stenosis progression, plaque vulnerability (e.g., intraplaque hemorrhage), or impaired cerebrovascular reserve. Conclusion: The management of ACAS has evolved towards a personalized, medical-first approach. Interdisciplinary collaboration is essential to identify high-risk patients who may benefit from revascularization while ensuring the majority receive optimized BMT. This strategy, supported by rigorous nursing coordination and advanced radiological diagnostics, optimizes outcomes by minimizing stroke risk and procedural harm.
Copyright (c) 2025 Sabah Abdulrahman Nasser Alshuhri, Mona Ahmed Kariri, Ashwaq Abdullrahman Nasser Alshehri, Mohammad Ayed H Alenizi, Majed Ahmed Abualsayl , Nawal Ahmed Abdu Hamdi, Fahid Ayed Awad Allah Al-Otaibi, Ameerah Mohammad Alharbi, Sharefa Mubark Aldosari, Zainab Muhammad Alharbi, Yousef Mohammed Shatyan Alharbi, Nouf Abdulrahman Alnamlah, Sultan Mufareh Ahmed Qusadi https://creativecommons.org/licenses/by/4.0
Hepatitis E Virus: Comprehensive Virological Insights, Diagnostic Strategies, and Laboratory Management for Clinical and Research Specialists
Background: Hepatitis E virus (HEV) is a major global cause of acute viral hepatitis, with significant morbidity and mortality in high-risk populations. It is a non-enveloped, single-stranded RNA virus transmitted primarily via the fecal-oral route, though zoonotic transmission is increasingly recognized. Aim: This review provides a comprehensive update on HEV for clinical and research specialists, covering its virology, diagnostic strategies, and laboratory management to improve detection and patient care. Methods: The synthesis is based on a detailed analysis of HEV's virological characteristics, including its genotypes and their distinct epidemiological patterns. Diagnostic approaches are evaluated, comparing serological assays (anti-HEV IgM/IgG) and molecular methods (PCR for HEV RNA) for acute and chronic infection. Results: HEV genotypes 1 and 2 cause waterborne outbreaks in developing regions, while genotypes 3 and 4 are zoonotic and responsible for sporadic cases in developed countries. Infection is often self-limiting but can lead to fulminant hepatitis in pregnant women and chronic infection in immunocompromised individuals. Diagnosis relies on a combination of serology and PCR, with the latter being essential for confirming chronic infection in immunosuppressed patients where antibody responses may be blunted. Conclusion: HEV is a complex pathogen with a variable clinical presentation. Accurate diagnosis requires an understanding of its virology and the strategic use of laboratory tests. Enhanced surveillance, targeted testing in high-risk groups, and a multidisciplinary approach are crucial for effective management and prevention.
Copyright (c) 2025 Neamat Bakr Ali Tukruna, Hind Saad Mohammed Alabdulsalam, Rashad Mohammad Hayan, Ateyah Laheg Nami Alhadri, Fatimah Sared Alsaiari, Ahmed Abdu Ahmed Zalah, Saleh Ahmad S Alebaidi, Mohammad Zaher Alblowi, Mahhani Hamad Jafar, Hadeel Hassan Almadkhly, Walaa Abdulwahed, Salihah Ahmed Allaghabi, Ahmed Moner Alqerafi, Majdi Raji Naffa Alharbi, Roaa Ahmed Dweiri https://creativecommons.org/licenses/by/4.0
Cardiac Rehabilitation: Integrated Approaches in Physical Therapy, Nursing, and Health Information Management
Background: Cardiovascular disease is the leading cause of death globally. Cardiac rehabilitation (CR) is an evidence-based, multidisciplinary intervention recommended for patients recovering from acute cardiac events or living with chronic cardiac conditions to improve functional capacity and reduce mortality. Aim: The primary aims of CR are to reduce the physiological and psychological burdens of cardiovascular disease, lower all-cause and cardiovascular-specific mortality, restore cardiopulmonary function, and enhance quality of life through structured, supervised programming. Methods: CR is delivered through phases, interprofessional programs integrating supervised, graded exercise training (aerobic and resistance), rigorous risk factor modification (e.g., lipid, blood pressure, and weight management), and structured psychosocial support and patient education. Programs are typically supervised and span approximately 12 weeks. Results: Participation in CR leads to significant improvements in functional capacity (e.g., VO₂ max), modifiable risk factors, and psychosocial well-being (reducing anxiety and depression). It demonstrably reduces hospital readmissions and long-term mortality. Furthermore, CR has an exceptional safety profile, with severe adverse events being exceptionally rare during supervised sessions. Conclusion: Cardiac rehabilitation is a cornerstone of cardiovascular secondary prevention, effectively improving clinical outcomes, functional status, and quality of life. Despite its proven benefits, utilization remains low due to systemic and patient-level barriers.
Copyright (c) 2025 Sarah Matar Alshammari, Nouf Alobaid Salem Alanazi, Shuruq Kaseb Ashwi Alanazi, Maali Munawir Alrashdi, Wgdan Sauod Alanzi, Ruwayda Hamed Yahya Sughayyir, Noura Jaber Al-Asmari, Duaa Mohammed Alithan, Khulud Saleh Ashamlani, Fawziah Tahoos Mubarak Alghamdi, Walaa Yahya Ali Muidh, Hamad Mohaimeed Hamad Alotaibi, Abdullah Hamood Alazmy https://creativecommons.org/licenses/by/4.0
The Second Victim Experience of Nurses Involved in Medical Mistakes: Systematic Review of Referral Processes, Feasibility, and Effectiveness
Background: The second victim syndrome is the intense emotional and professional damage caused to nurses by medical mistakes, but supporting mechanisms, particularly referral processes, are rudimentary. Aim: This review synthesizes evidence concerning referral processes among second victim nurses, examining their feasibility, limitations, and innovations to inform fair and effective support interventions. Methods: An integrative review was conducted searching PubMed, CINAHL, Scopus, and Web of Science (2000–2025) for peer-reviewed articles on second victim nurses. Forty sources, including qualitative, quantitative, and mixed-methods studies, were reviewed for themes of referral mechanisms, using thematic analysis and Joanna Briggs Institute appraisal instruments. Results: Referral automation happens in a mere 18% of organizations, with low awareness (74.8% unfamiliarity) and stigma as points of hindrance. Active models like MUHC's pager system and coordinated pathways bring rise to uptake, while innovations like the Talk to Me program achieve 100% uptake. Virtual programs externally (e.g., YANA) are 80% possible in under-resourced settings. Conclusion: Proactive, just culture-based referral systems are crucial to enabling second victim nurses, preventing distress, and enhancing patient safety.
Copyright (c) 2025 Sanaa Nasser Abuallah, Rana Shoai Ali Hady, Reem Shoue Ali Hadi, Aisha Ali Yahia Dahish, Nazekh Mohammed Ibrahim Aqeel, Weaam Ali Abkar Khalil , Badriah Saleh Colaib Jawhar, Halima Muhammad Ali Hakami, Sarah Mohammed Ali Hakami, Ishraq Yahya Mohammed Asiri https://creativecommons.org/licenses/by/4.0
Leveraging Blockchain Technology for Auditable and Privacy-Friendly Data Exchange in Teleradiology Networks
Background: Teleradiology, distant transmission and interpretation of medical images, has revolutionized healthcare by increasing diagnostic availability, particularly in underserved communities. However, its digital platform is vulnerable to threats of data breaches and invasions of privacy, with healthcare data breaches costing $2.1 million per breach in 2015. Aim: This review aims to address the history of safe data transmission and privacy protection in teleradiology, particularly through technological advancements, regulatory settings, ethical considerations, and challenges. Methods: A systematic review was conducted, and articles were fetched from PubMed, Scopus, IEEE, and ACM Digital Library. Keywords used were "teleradiology," "secure data exchange," and "privacy." Two tables of principal technologies and regulatory frameworks are given. Results: Advances in encryption, blockchain, AI, and IoMT provide security, but scalability, computational complexity, and regulation gaps pose obstacles. Ethical issues, including patient autonomy and trust, remain paramount. Case studies demonstrate that blockchain and AI are reducing tampering and data breaches. Conclusion: Security in teleradiology requires hybrid models, global regulatory harmonization, and patient-centric privacy frameworks to serve the requirements of access and protection. Scalability and equity must be tackled in future studies.
Copyright (c) 2025 Abdulelah Hassan Alhathiq, Abdullah Ahmed Rayyani, Mohammed Nasser Khawaji, Jebril Mohammed Mabuj , Akram Hadi Radwan, Lama Nasser Aloraini, Amjad Rashed Alorf, Heba Saad Alarifi, Sami Abdulaziz Alhuwaimel, Lina Abdulaziz Alrashed https://creativecommons.org/licenses/by/4.0
Interdisciplinary Management of Varicella-Zoster Virus Infection: Integrating Medical Treatment, Nursing Care, and Health Information Systems
Background: Varicella-zoster virus (VZV) is a highly contagious pathogen causing two distinct clinical entities: primary infection (chickenpox) and reactivation (herpes zoster). While often self-limiting in healthy children, VZV poses significant risks of severe complications in adults, immunocompromised individuals, and pregnant women, leading to hospitalizations and mortality. Aim: This article aims to provide a comprehensive, interdisciplinary review of VZV management, integrating perspectives from medical treatment, nursing care, and health information systems to optimize patient outcomes and public health control. Methods: The approach is a synthesis of current clinical guidelines and literature. It details diagnostic methods (clinical assessment, PCR, serology), medical management (antiviral therapy, symptomatic care), and public health strategies (isolation, vaccination, post-exposure prophylaxis). The role of nursing in patient education and supportive care, alongside the contribution of health information systems to surveillance and coordination, is emphasized. Results: Effective management hinges on risk stratification. Supportive care suffices for immunocompetent children, whereas early antiviral therapy (e.g., acyclovir) is critical for high-risk groups. Vaccination has dramatically reduced disease incidence and severity. Post-exposure prophylaxis with varicella-zoster immune globulin (VZIG) or vaccination can prevent or modify disease. Nursing care is vital for symptom relief and preventing complications like bacterial superinfection. Conclusion: A successful approach to VZV requires a coordinated, interprofessional model. Integrating timely medical intervention, dedicated nursing support, and robust health information systems is essential for reducing transmission, managing complications, and improving individual and population health outcomes.
Copyright (c) 2025 Masheal masoud alyami, Zainab Mohammed yahya Mobarki, Amnah Mohammed yahya Mobarki, Haila Hussain Alshaiban, Amna Aziz Al-Subaie, Maryam Mohammed Alnaji, Maryam Ali yahya jarah, Afiyah Mousa Ahmed Tawashi, Hanan Mohammed Sharahili, Sultan Mohammad Alkafif, ‏Abdullah Hamoud Almuayli, Abdullah Ibrahim Saleh ALburaidi, Amany Modhaya Ali Omair https://creativecommons.org/licenses/by/4.0
Integrated Rehabilitation and Nursing Management of Cervical Radiculopathy: A Multidisciplinary Perspective
Background: Cervical radiculopathy is a common condition caused by compression or inflammation of a cervical nerve root, leading to radicular pain, sensory disturbances, and motor weakness in the upper limb. It represents a significant source of disability and work absenteeism, with its etiology shifting from acute disc herniation in younger adults to spondylotic foraminal stenosis in older populations. Aim: This article aims to provide a comprehensive, multidisciplinary overview of the diagnosis, management, and rehabilitation of cervical radiculopathy, synthesizing perspectives from medicine, nursing, and physical therapy to guide evidence-based, patient-centered care. Methods: The approach is a synthesis of current clinical guidelines and literature. It details standardized diagnostic procedures, including clinical history, physical examination (e.g., Spurling's test), and confirmatory imaging (MRI) and electrodiagnostic studies. Management strategies are reviewed, encompassing conservative care (pharmacotherapy, physical therapy, injections) and surgical interventions (anterior discectomy and fusion, posterior foraminotomy). Results: The majority of patients with cervical radiculopathy experience favorable outcomes with conservative management, with many achieving functional recovery within months. For those with refractory symptoms or progressive neurologic deficits, surgical decompression provides more rapid pain relief and functional improvement. Effective outcomes depend on a coordinated, interprofessional approach that integrates accurate diagnosis, staged therapeutic interventions, and structured rehabilitation. Conclusion: Successful management of cervical radiculopathy hinges on a multidisciplinary model that prioritizes non-operative care initially and reserves surgery for specific indications. A team-based strategy, combining medical treatment, skilled nursing, and targeted rehabilitation, is essential for optimizing patient recovery, function, and long-term quality of life.
Copyright (c) 2025 Abdulrahman Mohammed Hakami, Saleh Mohammed Alotaibi, Dina Hamza M Farsi , Bader Mahmoud Alamri, Raheem Mohammed A Alhazmi, Reed Abdullah Abdu Barkat , Amani Mazyad Almutairi, Turki Ghazi Turki Alotaibi, Norah Mesfer Alqahtani, Huda Daifallah Al Saadi, Faisal Abdullah Al Faisal, Nasser Abdullah D Alkhurayyif, Abdulaziz Ibrahim M Alfaisal https://creativecommons.org/licenses/by/4.0
Integrated Nursing, Nutritional, and Health Information Perspectives on Folic Acid Deficiency: An Updated Review
Background: Folic acid (Vitamin B9) is a water-soluble micronutrient essential for DNA synthesis, erythropoiesis, and one-carbon metabolism. Deficiency disrupts these processes, leading to clinical consequences such as megaloblastic anemia, elevated homocysteine levels, and, critically, neural tube defects (NTDs) in developing fetuses. Despite public health measures like food fortification, deficiency remains a significant global health concern, particularly in vulnerable populations. Aim: This review aims to provide an integrated, multidisciplinary perspective on folic acid deficiency, synthesizing its etiology, pathophysiology, clinical manifestations, and management strategies from nursing, nutritional, and medical viewpoints to guide comprehensive patient care and public health initiatives. Methods: The approach is a comprehensive literature review and clinical synthesis. It details the diagnostic evaluation, including clinical assessment, complete blood count analysis, and biochemical testing (serum/red blood cell folate, homocysteine, and methylmalonic acid levels). Management strategies, from oral and parenteral supplementation to dietary modification and public health fortification, are examined. Results: Folic acid deficiency has a multifactorial etiology, including inadequate dietary intake, malabsorption syndromes, medications, and increased physiological demand. Diagnosis is confirmed through characteristic macrocytic anemia and low folate levels. Treatment with oral folic acid (1-5 mg/day) is highly effective, leading to hematological recovery within weeks. Public health fortification programs have successfully reduced the prevalence of deficiency and NTDs in many countries. Conclusion: A collaborative, interprofessional approach is fundamental to the effective prevention, diagnosis, and management of folic acid deficiency. Integrating medical treatment, nursing care, nutritional counseling, and public health strategies is essential to mitigate its hematological, neurological, and developmental consequences.
Copyright (c) 2025 Zahra Mohammed Marwaie Khobrani, Khalid Muaybid Mohammed Alharbi, Abrar Mohammed Alanzi, Mutaib Abdulrahman Mukhlid Alotaibi, Saad Hazzaa Gazi Aljsh, Mohammed Ali Aldahmali, Jamilah Shutayt M Alharbi, ‏Mohammad Ayed H Alenizi, Ibrahim Ataya Ali ALzubudie , Abdulrhman Mohmmed Al Sahli, Abdullah Nuwaysh Saud Alotaibi, Abdullah Ghanem Almutairi, Abdulrahman Saud Mohammad Al Sulaiman https://creativecommons.org/licenses/by/4.0
Micro-Credentials and Skill-Based Stacking in Nursing: A Narrative Review
Background: The nursing profession is faced with new challenges that have never been seen before, including workforce shortages, technological advances, and demands for advanced skills. Traditional degree programs are slow to respond to these shifting needs at such a fast rate, so micro-credentials—short, competency-based certificates—are arising, and skill-based stacking, which layers the credentials into modular career tracks, is underway. Aim: The objective of this review is to synthesize the role of micro-credentials and skill-stacking in nursing education, their application, benefits, drawbacks, and future uses. Methods: A narrative review was undertaken comparing peer-reviewed papers (2018–2025) published in PubMed, CINAHL, and Google Scholar. Sources were selected for relevance to nursing education, workforce development, and credentialing, with a focus on stakeholder perspectives, empirical evidence, and global trends. Results: Micro-credentials build clinical expertise (e.g., 15% reduced mortality by sepsis training) and employability (90% employer preference), and stacking raises earnings by 89% in five years. Challenges are inconsistency regarding terms utilized (45% of research), low employer validation (40% skepticism), and access limitation for rural nurses (22% stacking rate). AI and VR technologies hold scalability potential but need ethical governance. Conclusion: Micro-credentials and stacking offer equitable, flexible solutions to nursing shortages, requiring standardization and policy support to realize their full impact.
Copyright (c) 2025 Asma Khulaif Almutairi, Hanan Awad Alshahrany, Fatma Ali Alhaqab, Reem Mansour Alqurshi, Amal Khalaf Alanazi, Ramdaa Khulaif Almutairi, Saleh Salem ALjeri , Fatima Saleh Hassan Alshmimri, Fatimah Manaour Altowairqi, Ahmed Naji Alsahabi https://creativecommons.org/licenses/by/4.0
Assess the application of Jojoba seed coating in the fabrication of silver nanoparticles and their subsequent utilization as antibacterial agents
Green synthesis is a method that uses plant waste to produce nanoparticles that is environmentally beneficial. It reduces plant waste and eschews the harsh chemicals frequently utilized in the typical manufacture of nanoparticles. These nanoparticles are generally thought to be less hazardous than those that are created chemically. green silver nanoparticles exhibit potential as antibacterial agents. They can potentially fight against numerous disease-causing bacteria, helping to public health. In this study, extract from jojoba seed coat (JSC) was used to create green silver nanoparticles thenThe potent chemical components were identified by identifying the active chemicals and groups in the generated materials and characterization of the nanoparticles using FTIR and a GC-Mass. After that, the nanoparticles were investigated and clarified utilizing TEM, Zeta potential, FTIR, and EDX equipment.
Copyright (c) 2025 Mohammed Ahmed Ali Elshaer, Yasmeen A. Hasanien, Mervat Mostafa Abdel Mageed, Abd-elfattah Darwish, Mohamed Awad Mahmoud Abd-Elraheem, Loay Hassan Jubran, Mohammed Abdullah Safar Alamri, Mead Mohammed Al masalm, Aishah Ali Ahmed, Khulud Mohammed Asiri, Fatima Abdullah Alamri, Aisha Abdullah Safar Alamri https://creativecommons.org/licenses/by/4.0
Perioral Dermatitis: Clinical Considerations for Dental, Pharmacy, and Nursing Professionals
Background: Perioral dermatitis is a common inflammatory facial dermatosis, clinically characterized by erythematous papules and pustules distributed around the mouth, nose, and eyes. It predominantly affects young adult females and is frequently linked to the use of topical corticosteroids, which can initiate a cycle of steroid dependence and rebound flares. The condition's multifactorial etiology also involves other triggers like fluorinated toothpaste, occlusive cosmetics, and skincare products. Aim: This article aims to synthesize the clinical presentation, pathophysiology, and management of perioral dermatitis for an interprofessional audience, including dental, pharmacy, and nursing professionals. The goal is to enhance recognition, promote trigger identification, and guide effective, steroid-sparing treatment strategies to improve patient outcomes. Methods: A comprehensive review of the condition is presented, covering its clinical features, histopathology, and epidemiology. Diagnostic approaches based on morphology and exposure history are detailed, alongside a systematic overview of management strategies, including topical and oral therapies, with a strong emphasis on corticosteroid cessation and trigger avoidance. Results: The cornerstone of management is the immediate discontinuation of all facial corticosteroids, often requiring a structured taper to mitigate rebound flares. First-line therapies include topical metronidazole, calcineurin inhibitors, and azelaic acid. For moderate-to-severe cases, oral tetracyclines are highly effective. Adjunctive measures, such as simplifying skincare routines and substituting potential irritants, are critical for achieving and maintaining remission. Conclusion: Perioral dermatitis is a frequently mismanaged condition that requires a coordinated, interprofessional approach. Successful outcomes depend on accurate clinical diagnosis, patient education trigger avoidance, and the consistent application of steroid-sparing therapeutic regimens to break the cycle of dependency and inflammation
Copyright (c) 2025 Mohammed Ahmed Ali Elshaer, Yasmeen A. Hasanien, Mervat Mostafa Abdel Mageed, Amira Abd-elfattah Darwish, Mohamed Awad Mahmoud Abd-Elraheem https://creativecommons.org/licenses/by/4.0
Emergency Management of Febrile Seizures: Clinical Assessment and First Aid Interventions in Prehospital and Emergency Settings
Background: Febrile seizures are the most common neurological disorder in early childhood, affecting children between 6 months and 5 years of age. They are convulsive events associated with a fever, distinct from intracranial infections or pre-existing epilepsy, and while generally benign, they are a frequent cause of caregiver anxiety and emergency department visits. Aim: This article aims to outline the evidence-based clinical approach to febrile seizures, focusing on accurate diagnosis, acute management, and appropriate diagnostic workup to distinguish simple from complex presentations and rule out serious underlying conditions. Methods: A comprehensive review of the etiology, pathophysiology, and classification of febrile seizures is presented. The evaluation and management strategies are detailed, emphasizing a thorough history and physical examination to guide selective use of diagnostic tests such as lumbar puncture, electroencephalogram (EEG), and neuroimaging. First-line pharmacological interventions for prolonged seizures are also discussed. Results: The majority of febrile seizures are simple, self-limited, and require no specific treatment beyond identifying and managing the underlying febrile illness. Complex febrile seizures (prolonged, focal, or recurrent within 24 hours) warrant a more extensive evaluation to exclude serious pathologies like meningitis or structural abnormalities. Rescue benzodiazepines are effective for aborting prolonged seizures in prehospital and emergency settings. Conclusion: The management of febrile seizures is primarily supportive and focused on reassurance. A structured, interprofessional approach ensures safe, effective care, minimizes unnecessary interventions, and provides crucial education to caregivers.
Copyright (c) 2025 Mohammad Ageel Hassan Alghamdi, Emad Mohammad Salem Alqarni, Abdullh Othman Ahmad Alghamdi, Khaled Ahmad Eisi Khormi, Ahmad Amer Ahmad Al Shehri https://creativecommons.org/licenses/by/4.0
Relationship between patient satisfaction with nursing services and health awareness levels
Patient satisfaction and health awareness are necessary pointers of quality healthcare, especially in nursing services where direct contact with patients is common. The study will examine the connection between patient satisfaction with nursing care and the degree of health awareness of patients. It also looks into the impacts of effective communication, empathy, cultural sensitivity, patient education and hospital environment in patient perceptions and health behaviors. Good health awareness helps patients to manage their health conditions, take prescription and do preventive measures, which increase patient satisfaction and confidence in nursing services. Health education programs and awareness campaigns conducted by the nurse are vital in enhancing patient knowledge, empowerment of self-management of chronic diseases, and proactive health behavior. The results also indicate that incorporating health literacy in nursing practice does not only enhance patient satisfaction, but also improves health outcomes. The Interplay between nursing services and patient health awareness is a vital understanding which is necessary to provide patient-centered care, enhance compliance to treatment, and create successful health promotion models.
Copyright (c) 2025 Noran Mohammed Alghamdi, Nadyah Khalaf Safi Alanazi, Dalal Khalaf Safi Alanazi, Ghadeer Hemaidan Altalhi, Alanoud Salman Alshalawi, Ghadah Mousa Naseeb, Mona Awadh Alanazi, Fatimah Tuwaileh Almasoudi, Najla Awadh Sattam Alanazi, Amirah Oudah Alanazi, Zaina zaki Almohammed, Fatmah Ali Khrami, Bader Majed Alotaibi, Ilham Muhammad Albalawi, Ramzi Hasan Al hamad, Aseel Hasson Alhasson https://creativecommons.org/licenses/by/4.0
The Progress in Imaging Technologies and Implications for Nursing Practice: A Systematic Review
Background: The recent years have seen revolutionary advancements in medical imaging technologies, including artificial intelligence (AI), point-of-care ultrasound (POCUS), and hybrid imaging modalities like PET/MRI. These technologies have transformed diagnostic and therapeutic interventions. These technologies provide unprecedented functional and molecular information, with new implications for clinical care beyond traditional radiology. Aim: The aim of this review is to synthesize the literature from 2015 through 2025 to explore how these imaging technology advances are redefining nursing roles, responsibilities, and competencies. Methods: A Systematic literature review from 2015 through 2025 was conducted. The reviews were evaluated to assess the implications of the emerging imaging technologies for nursing practice within various clinical settings. Results: The outcome reflects a paradigm change for the nursing practice from a passive taker of imaging data to an active participant in the imaging cycle. Key implications are the increased responsibility in patient preparation for complex scans, intra-procedural surveillance, bedside data interpretation by POCUS, and the management of clinical alerts based on AI. Such development involves significant educational demands and ethical concerns of data privacy and accountability of algorithms. Conclusion: Advanced imaging technologies are irreversibly transforming nursing practice, demanding an innovative approach. To ensure patient safety and optimal outcomes, the profession must develop standardized curricula for education, foster robust interprofessional relationships, and establish explicit competency frameworks and policies to support nurses in this high-technology practice environment.
Copyright (c) 2025 Mohammad Abdrabalhabeeb Salm Lahmadi, Fahad Mohmmed Saead Alqhtani, Suad Mubarak Mohammed Aldossary, Saleh Ashway Nahar Alshammari, Hisham Saleh Zidan, Khaled Lafi Mansi Al Dhafiri, Abdallah Saad Said Aldosery, Badrea Asri Alenazy, Hussain Kadhem S Al Shuwaish, Anwar Mohammed Alsharedi, Nawal Ali Ali Awaji, Fahad Obaidallah Ataallah Alreshidi https://creativecommons.org/licenses/by/4.0
Oral Health Considerations for Patients With Systemic Diseases: Implications for Dental and Nursing Practice
Background: The demographic shift towards an aging population retaining more teeth, combined with a rising prevalence of chronic systemic diseases, means dental practitioners increasingly treat medically complex patients. This necessitates a move beyond routine care to a model that rigorously accounts for systemic health. Aim: This article aims to delineate the critical considerations and protocols required for the safe and effective delivery of dental care to patients with systemic diseases, emphasizing a collaborative, interprofessional approach between dental and nursing professionals. Methods: The approach involves a comprehensive synthesis of current evidence and guidelines. It advocates for a structured process integrating meticulous medical history-taking, medication reconciliation, and patient-specific risk stratification using tools like the ASA classification and Charlson Comorbidity Index. The methods highlight the need to interpret how conditions like cardiovascular disease, diabetes, and immunosuppression interact with dental procedures. Results: The analysis confirms that even minor dental interventions can precipitate significant systemic consequences in vulnerable patients. Key findings provide specific guidance on managing patients with hypertension, coagulopathies, and those undergoing cancer therapy or taking medications like antiresorptives and immunosuppressants. Successful outcomes are shown to depend on interdisciplinary coordination, robust local hemostasis, and staged care to avoid interrupting essential medical therapies. Conclusion: Safe dental care for medically complex patients is achievable through a dynamic, patient-centered model grounded in comprehensive assessment, evidence-based risk mitigation, and seamless collaboration between dentists, nurses, and physicians.
Copyright (c) 2025 Sultan Mohammed Alamri, Malak Khalid Alharthi, Nawal Jubran Salawi, Mansour Awad Mulhaq Alotaibi, Moatsem Eid Saleh Alsenani, Abdulrahman Saud Mohammed Al Suliman, Lama Khaled Al-Zaini, May Ayed Alanazi, Hanan Salah Almutairi, Noura Mohammed Alshahrani, Maha Nasser Alwasel, Sarah Ali Ibrahim Hakami https://creativecommons.org/licenses/by/4.0
Copyright (c) 2025 Saad Laiban B Al Rowaili, Ali Saeed Al Alshiak, Abdullah Esse Al khamis, Adel Abdullah Al Shggag, Eman Ghannam Alotaibi, Maha Shreedah Alenazi, Dalal Mohmmed Al-Dosiry, Azhar Ali Albdiawy, Mohammed Ibrahim A Alrajal, Abdullatif Abdulrhman Alsaeed, Fatimah Saeed Alyagoub, Dhaha Hassan Al-Saffar https://creativecommons.org/licenses/by/4.0
A Systematic Review of Post-Fall Care: Developing an Integrated Continuum from Medical Assessment to Functional Rehabilitation
Background: Falls in older adults are a frequent global health occurrence, a sign of physiologic failure, and lead to injury, functional decline, fear of falling, and death. In spite of prevention measures, postfall care is often fragmented, focusing on the management of injury and neglect of etiology. Aim: This review aggregates current evidence to propose a standardized, patient-centered plan for comprehensive post-fall care aimed at addressing gaps in care from the time of initial response through long-term restoration of function. Methods: A narrative review of recent literature (2025) was conducted to summarize and synthesize evidence on the components of an optimal post-fall pathway, including initial assessment, interdisciplinary study, and rehabilitation strategies. Results: The results present an uninterrupted, five-step process: 1) Initial nurse response and triage; 2) Complete medical workup to determine etiology; 3) Interdisciplinary care planning; 4) Restoration of function through physical and occupational therapy; and 5) Secondary prevention and transition planning. This model emphasizes the key roles of all health care professionals in creating a unitary care continuum. Conclusion: This integrated, multidisciplinary practice can transform a fall from an incident to an opportunity for holistic assessment, proactive prevention of subsequent risk, preservation of patient autonomy, and improvement in quality of life.
Copyright (c) 2025 Sumaiah Abdullrhman Hassan Al-Saloli, Fatimah Fahad Alnasser, Fahad Hasil Alasmari, ‏Mohammad Ayed H Alenizi, Mona Mohammed Alanazi, Eman Mohsen Yahya Zabr, Abdullah Sultan M Alsahli, Abdullah Hamoud Mohammed Almazyad, Abduaziz Rashed Zaid Bin Gannam, Nasser Faleh M Alghatani, Abdallah Saad Said Aldosery, Tahani Rashed Awad Alruwaili, Naif Saad Alsahla https://creativecommons.org/licenses/by/4.0
The Role of Community Health Nurses in Promoting Maternal and Child
Maternal and child health (MCH) is one of the pillars of health in the population, as it demonstrates the health status and progress of the nation. Community health nurses have a crucial role in MCH promotion by offering preventive health care, health education and by providing direct services to people on the grassroots level. The study aims to address the topic of The Role of Community Health Nurses in Promoting Maternal and Child Health by delving into their roles, issues, and input into the functioning of the systems of public health, The paper explains the history and importance of MCH, what is meant by community health nursing and the history of the nursing practice in the community. It emphasizes the critical functions of community health nurses in health promotion, disease prevention, prenatal and postnatal care, immunization, nutrition surveillance, and family based intervention. Moreover, it examines the international and regional issues influencing MCH and determines the obstacles to the efficiency of nurses including the lack of resources, cultural factors, and policy restrictions. The importance of ethical considerations, cultural sensitivity, and interprofessional cooperation are highlighted as some of the major aspects of effective community nursing. The role of health policies, evidence-based practice integration, and modern innovations, including telehealth, mobile health technology, and other innovations, that have revolutionized community care, are also discussed in the paper, the study gives recommendations and future goals of improving MCH by creating better infrastructure, ongoing training of nurses and fair health policies. The results highlight how the provision of appropriate resources, education, and support to community health nurses can help considerably decrease maternal and child morbidity and mortality. To enhance their contribution will thus be crucial in attaining universal health cover and creating healthier and more resilient societies all over the world.
Copyright (c) 2025 Ali Khalid Abdullah Bin Nashar, Thahab Ahmed Mohamed Hanan, Mohammad Muslah Alshaibani, Hadiah Qari Awaji, Afnan Naseer Knadiry, Salman Ibrahim Alomran, Fatimah Essa Alonayzan, Mona Tobean Rasheed Alrwili, Ehab Ali Hussin Jubran, Ghada Ali Albeladi, Majed Abdullah Salem Altarfan, Rana Ayash Al Hmadi , Mamdouh Ramadan Alenazi https://creativecommons.org/licenses/by/4.0
The "Warm Handoff" Protocol: Systematic Review of Training to Support Effective Transfers of Care between the Emergency Department and Primary Care
Background: Emergency Department-to-primary-care handoff is a high-risk time for breakdown in communication. Asynchronous, written traditional practice, such as instructions, frequently leads to loss of information, threatening patient safety and continuity of care. "Warm Handoff" is a structured, synchronous, verbal handover between clinicians that can be the answer to this critical gap. Aim: The present systematic review synthesizes the current evidence base (2015-2025) on standardized communication training programs for preparing ED nurses and physicians with the skills required to execute effective warm handoffs directly to clinic-based teams. Methods: Recent literature was reviewed to examine the critical components of successful training curricula, evaluate their impact on patient, provider, and system outcomes, and identify the most significant implementation challenges and facilitators. Results: Formal warm handoff training has been shown through evidence to effectively reduce communication errors, improve patient satisfaction and follow-up compliance, decrease unnecessary ED recidivism, and enhance professional satisfaction among both primary and ED staff. However, implementation is threatened by workflow integration, technical support, and interprofessional hierarchies. Conclusion: Universal adoption and standardization of warm handoff training protocols are essential to building a safer, more reliable, and patient-centered healthcare system, as high as there are significant implementation challenges.
Copyright (c) 2025 Abduallah Mohameed Huseen Ayashi, Moayed Abdullah Mohammed Alqarni, Ahlam Mohammed Mose Hakamie, Feras Abdullah Al-Fardan, Ahmad Hassan Albashrawi, Mohammad Jaffar Al Rumaih, Eisa Jafar Morabit, Hassan Mohammed Al Ramadan, Asim Ibrahim Ali Moafa, Shahad Jabbari, Sultan Badah Alharbi, Ishaq Rubayyi Mukhlef Alhazmi https://creativecommons.org/licenses/by/4.0
Outcomes of Levofloxacin-Based Regimens in Adults With Severe Community-Acquired Pneumonia Requiring ICU Admission: A Single-Center Retrospective Cohort From Jazan, Saudi Arabia
Background Levofloxacin is widely used in combination regimens for severe community-acquired pneumonia (CAP) in the ICU; however, real-world outcome data from resource-limited settings remain scarce. Objective: To evaluate 28-day mortality and key clinical/safety outcomes among adults with severe CAP requiring ICU admission who received levofloxacin-based regimens at Abu-Arish General Hospital. Methods We conducted a retrospective cohort study that examined patient data captured through an electronic medical system at the Abu Arish General Hospital between 2021 and 2022 (Single‑center retrospective cohort (dates), Abu‑Arish General Hospital ICU). We used the repeated measures ANCOVA to investigate the effect of Levofloxacin on a wide range of medical parameters. Data analysis was performed with SPSS statistics (Version 25). Results A total of 93 patients were included in this study. The study examined the impact of levofloxacin on various medical parameters, including age, weight, height, BMI, initial dosage, comorbid diseases and sex. The adjusted mean differences between before and after Levofloxacin administration revealed significant changes in a variety of medical parameters, including hepatic markers and hematologic indices. Conclusion Levofloxacin therapy can produce change in baseline clinical characteristics of critical ill patients in the intensive care unit. We need to investigate the tolerability of this therapy in terms the severity of side effects on a large sample of the critically ill patients in the future. This study will allow healthcare providers to give better care to these patients.
Copyright (c) 2025 Ahmed Hakami, Amnah Numan, Shoroog Obaidullah, Shahad Numan, Ahmad Alharbi, Hanan Hakami, Hanan Bakri, Nawal Hakami, Mousa Zamili, Abdulmajeed Alanazi, Munif Ayyashi, Ali Mohammed Qassim Hazzazi https://creativecommons.org/licenses/by/4.0
Interdisciplinary Approaches to Cholestatic Jaundice: Diagnostic, Pharmacologic, and Nursing Perspectives
Background: Cholestatic jaundice is a syndrome resulting from impaired bile formation or flow, leading to the systemic accumulation of biliary constituents like bilirubin and bile acids. It is clinically categorized into intrahepatic causes, affecting hepatocytes or small ducts, and extrahepatic causes, involving mechanical obstruction of the large bile ducts. Aim: This article aims to provide a comprehensive, interdisciplinary overview of the diagnostic, pharmacologic, and nursing management of cholestatic jaundice, emphasizing the integration of clinical evaluation, targeted testing, and collaborative care to optimize patient outcomes. Methods: The approach involves a systematic diagnostic workup beginning with clinical history, physical examination, and liver biochemistry. Key methods include imaging, notably ultrasound to detect ductal dilation, followed by MRCP or ERCP for definitive diagnosis and intervention in obstructive cases. For intrahepatic causes, serologic testing and liver biopsy are employed to identify etiologies such as drug-induced injury, autoimmune cholangiopathies, or genetic disorders. Results: Management is etiology-driven. Extrahepatic obstruction requires timely biliary decompression via endoscopic, percutaneous, or surgical methods. Intrahepatic cholestasis management focuses on treating the underlying disease, managing pruritus with a stepped pharmacologic approach (e.g., bile acid sequestrants, rifampin, naltrexone), and correcting nutritional deficiencies, particularly of fat-soluble vitamins. Conclusion: Effective management of cholestatic jaundice hinges on accurate anatomical localization of the defect and a multidisciplinary, patient-centered approach. Collaboration between gastroenterologists, radiologists, surgeons, nurses, and pharmacists is essential for timely diagnosis, intervention, and supportive care, ultimately improving symptom control and preventing long-term complications.
Copyright (c) 2025 Musab Mohammed Faqihi, Hana Mohammed S Al-Anazi, Abdulaziz Masad Alharbi, Ahmed Mohammed Ahmed Othman, Aseel Jamil Ahmed Othman, Khaloud Abdullah Alnassar, Amnah Muharib Alanazi, Waleed Hassan Zaylaee, Khalid Fahd Ali Alrushaidan, Hamdah Mutair Awadh Alenazi, Sultan Omar Ahmed Hakami, Ibrahim Essa Jaafari, Amal Ali Makki Hanshli https://creativecommons.org/licenses/by/4.0
Viral Gastroenteritis: Clinical Manifestations, Nursing Care Strategies, and Health Data Perspectives
Background: Viral gastroenteritis, commonly known as the "stomach flu," is a highly contagious infection causing inflammation of the stomach and intestines. It is a major global health concern, leading to significant morbidity, healthcare burdens, and economic costs, with norovirus and rotavirus being the most prevalent pathogens. Aim: This article aims to provide a comprehensive overview of viral gastroenteritis by synthesizing its clinical manifestations, outlining evidence-based nursing care strategies, and exploring the role of health data analytics in improving prevention, outbreak management, and public health surveillance. Methods: The review synthesizes current clinical guidelines and best practices. It details the diagnostic approach, which is primarily based on clinical presentation and symptom assessment, with laboratory confirmation reserved for severe or outbreak scenarios. Nursing interventions are framed within a patient-centered model, focusing on thorough assessment, hydration management, and education. Results: The primary clinical manifestations include acute onset of watery diarrhea, vomiting, abdominal cramps, and nausea, which can lead to dehydration and electrolyte imbalances, particularly in vulnerable populations. Effective management is centered on vigorous oral or intravenous rehydration. Results highlight that meticulous nursing care—encompassing fluid balance monitoring, symptom control, and strict infection prevention protocols—is critical to patient recovery and containing transmission. Furthermore, leveraging health data enables real-time outbreak detection and informs targeted public health interventions. Conclusion: A multifaceted approach combining prompt clinical management, diligent nursing care, and robust health data systems is essential for reducing the impact of viral gastroenteritis.
Copyright (c) 2025 Reham Hussain Hamami, Jawaher Ali Makey Hanshali, Walaa Mohammed Almanbahi, Farhah Falah Srayan Alenezi, Amani Mazyad Almutairi, Mona Abdulaziz R Almotiab, Nada Mosa Alhalawi, Faisal Mohammed Ali Amri, Faisal Lafi Al-Mutairi, Eman Mohammed Ali Amri, Manal Zaal Amesh Al-Rashidi, Abdallah Saad Said Aldosery, Nasser Faleh M Alghatani, Abduaziz Rashed Zaid Bin Gannam https://creativecommons.org/licenses/by/4.0
The Effect of an Interdisciplinary Nursing-Pharmacy-Laboratory "Sepsis Huddle" on Time-to-Antibiotic Administration: A Systematic Review
Background: Sepsis and septic shock are high-priority global international health problems, and early recognition of both is crucial to survival. The Surviving Sepsis Campaign highly recommends antibiotics within one hour of recognition, but there are still considerable delays in emergency and inpatient settings due to systemic and communication failures. Aim: This systematic review evaluates the evidence for a multidisciplinary "sepsis huddle" and its implementation as a means to improve antibiotic timeliness and one-hour goal achievement. Methods: A Literature synthesis between 2015 and 2025 was conducted to examine the impact of sepsis huddles, typically nurse-initiated, with involvement of laboratory and pharmacy personnel for early diagnosis and preparation of antibiotics. Results: Sepsis huddle implementation routinely demonstrated significant improvement in the percentage of patients treated with antibiotics within an hour, with reduced median door-to-antibiotic times. The intervention was also associated with positive secondary outcomes, including reduced hospital length of stay and in-hospital mortality. Success is attributed to concurrent activation of primary processes: early identification by nurses, prompt laboratory support, and anticipatory pharmacy engagement. Conclusion: The sepsis huddle is an effective, multi-professional intervention for promoting time-sensitive sepsis bundle compliance. Future efforts must work to standardize its components and overcome implementation barriers to optimize patient outcomes.
Copyright (c) 2025 Jabril Ali Hakami, Anwar Ali A Hakami, Wejdan Abdu M Jafar, Amunah Mohammed Ahmed Hakami, Sarah Mubarak M Aldawsari, Salha Mohammed Al-Thrwy, Fahad Eidhah S Alharthi, Ahmad Saud Alhejaili, Abdul Rahim Badi Awad Al Harbi, Majed Ahmed Mohamed Badwialan, Salmah Mashhi Hamad Aldhafeeri, Yasser Abdrab Alamir Khalifa Alkuwaiti https://creativecommons.org/licenses/by/4.0
A Systematic Review of Multidisciplinary Care of Acute Agitation in the Emergency Department: De-escalation, Pharmacology, and Disposition
Background: Acute agitation in the emergency department (ED) is a common, high-risk symptom that occurs secondary to diverse psychiatric, medical, substance-related, and psychosocial emergencies. Treatment has historically been reactive in nature, with a focus on physical restraint and involuntary sedation. A contemporary paradigm shift favors a proactive patient-centered multidisciplinary approach to improve safety and outcomes. Aim: This review synthesizes evidence from 2015 to 2025 to evaluate the efficacy of integrated, multidisciplinary protocols for managing acute agitation. It specifically assesses the roles of nursing de-escalation, physician medical evaluation, pharmacist-informed pharmacology, and social services-led disposition planning. Methods: An extensive review of the literature was performed, synthesizing research on protocols that officially combine non-pharmacological and pharmacological approaches. Interdisciplinary collaboration and its effects on major clinical, safety, and operational indicators were the focus. Results: The literature conclusively substantiates that coordinated, team-based protocols significantly enhance patient and staff safety by reducing physical restraints and seclusion. They reduce negative clinical outcomes, enhance adherence to evidence-based standards, and enable more suitable and humane patient dispositions. Success is contingent upon systematized order sets, frequent staff training, and seamless coordination between disciplines. Conclusion: The optimal care of acute agitation is a multidisciplinary process. Integrated protocols that utilize the unique skill set of nursing, medicine, pharmacy, and social services are superior to the previous fragmented systems and translate into safer, more effective, and more dignified patient care.
Mohammed Abdulaziz Abdul Mohsen Al-Sultan
Copyright (c) 2025 Khaled Abdul Rhamn Al-Dkhail, Hussain Hamad Nasser Alhussain, Majed Abdullah Othman Alothman, Ibrahim Fahd Abdalazez Alhussain, Mohammd Hamad Nasser Alhussain, Mohammed Abdulaziz Abdul Mohsen Al-Sultan, Hudaib Mohameed Alsultan, Hassan Ali Mohammed Kaseb, Majed Ahmed Abualsayl, Saeed Obied Saad Aldowssri, Bader Nasser Kurim Alotaibi, Azzam Ali Hamoud Alharbi https://creativecommons.org/licenses/by/4.0
The Prescription for Value and Efficiency: A Systematic Review of Artificial Intelligence in Optimizing Pharmacy Business and Drug Prices
Background: Healthcare is facing unprecedented stress due to the threat of rising costs, drug shortages, and inefficiency in operations. Pharmacy operations, starting from the manufacturing plant to the patient's bedside, and the complex nexus of drug prices are important areas crying out for disruption. Artificial intelligence (AI), specifically machine learning (ML), natural language processing (NLP), and robotic process automation (RPA), is being viewed increasingly as a game-changing force that can help counter these problems. Aim: The aim of this systematic review is to integrate current literature and evidence on the application of AI for streamlining pharma operations and justifying drug cost. Methods: We systematically searched peer-reviewed articles, reports, and clinical trials published between 2010 and 2025. Results: The findings reflect that AI-based solutions are being used effectively across the value chain of pharma. In operations, AI systems streamline inventory management, automate dispensing, improve clinical decision support, and personalize medication adherence programs. In drug pricing, AI algorithms are transforming market access approaches, optimizing payer reimbursement contracts, and informing value-based pricing models using advanced analysis of real-world evidence (RWE). Although the potential is great, numerous challenges remain, including data privacy concerns, algorithmic bias, the "black box" issue, and regulatory challenges. Conclusion: The review opines that AI is not only an incremental but also a paradigm change towards improved, safer, and value-based pharmacy practice. Strategic investment, cross-disciplinary convergence, and robust regulatory frameworks are essential to unlock the full potential of AI in creating an enduring and patient-centric pharmaceutical system.
Copyright (c) 2024 Ahmed Ali Mussa Naji, Rehab Moaied Abdo Bagal, Ali Hassan Ibrahim Khormi, Abdulrahman Yahya Ahmed Masrai, Asim Omar Mohammed Hakami, Ahmed Mohsen Mohammed Maswdi, Mohammed Saleh Mohammed Sayed, Ahmed Hussain Ahmed Zalah, Mohammed Mohsen Abdu Khormi, Talal Qasim Mosa Mashragi, Ibrahim Abu Bakr Hakami, Ahmad Nahari Mohammad Madkhali, Abdullah Mohsen Mohammed Maswdi, Ahmad Abdullah Ali Majrashi, Mazen Qassem Buhais Ozaybi, Radwan Yehya Salim Moudhah https://creativecommons.org/licenses/by/4.0
Cultural Competence in Nursing and Laboratory Services: A Systematic Review of the Influence of Cultural Factors on Patient Interactions and Health Outcomes
Background: Global migration and increasing cultural diversity have made cultural competence a necessary component of quality health care. In clinical practice, nursing and laboratory services are major patient interfaces where culturally mediated beliefs, behaviors, and communication styles directly influence the process of care. Mismatch in these interactions can lead to misdiagnosis, non-adherence, and health disparities. Aim: This systematic review aims to synthesize the literature between 2015 and 2025 to understand how cultural factors impact patient interactions in nursing and laboratory practice and to evaluate strategies for developing cultural competence in these services. Methods: A systematic search was conducted in PubMed, CINAHL, PsycINFO, and Scopus. The search terms used were "cultural competence," "nursing," "phlebotomy," "laboratory medicine," "patient interaction," "health disparities," and "cultural factors." Results: Cultural factors significantly impact care, including explanatory models, communication barriers, religion-based preferences, and family involvement. These factors affect patient consent, compliance, and follow-up care. Interventions like professional medical interpretation, cultural competency training, and culturally tailored patient education improve patient satisfaction and diagnostic accuracy. Conclusion: Cultural competence is crucial for safe, effective, and equitable nursing and laboratory practice. Institutional policy should include trained interpreters, culturally sensitive protocols, and a diverse workforce, promoting cultural humility.
Copyright (c) 2025 Yahya Ahmed Mohammed Hazazi, Mohammed Saleh Najdi, Nader Marshood Rasheed Alsadi, Nasser Yhaya Ghallah, Salem Zaid Al-Amer, Faisal Hassan Mawkili, Saad Mohsan Alshaibani, Mubarak Dwayehm ALdawsari, Abdulaziz Salem Alghamdi, Azzam Ali Hamoud Alharbi, Abdullah Mubarak Abdullah Almesan, Mohammed Saleh Ayad Aljohani, Marwa Abdo Ahmad Madkhali https://creativecommons.org/licenses/by/4.0
A Systematic Review of Quality Improvement Initiatives Led by Radiology Nurses in Diagnostic Imaging Services
Background: The diagnostic imaging department is a high-risk, complex setting with patient safety, operational efficiency, and patient experience as the priorities. Within this setting, the radiology nurse's role has transformed significantly from procedural to core coordination and leadership of quality improvement (QI). Aim: This synopsis synthesizes literature between the years 2015 and 2025 to examine the extent, impact, and characteristics of QI activities driven or sponsored by radiology nurses. Methods: A Systematic review of peer-reviewed articles was conducted. Top scholarly databases were used to conduct literature searches, and studies were included if they described nursing-led QI projects within diagnostic imaging and quantified outcomes. Results: The findings demonstrate how evidence-based care by radiology nurses is important in closing four areas of high value: patient safety (i.e., reducing contrast reactions and falls), patient experience, operational effectiveness, and safety culture. These evidence-based approaches yield significant reductions in adverse events, higher levels of patient satisfaction, increased throughput, and cost savings. Standardized checklists, anticipatory risk analysis, and robust patient education are among common success factors, but pitfalls like role ambiguity and limited resources remain. Conclusion: Radiology nurses are strong leaders of QI in imaging and not just implementers. Providing them with formal leadership training and clear role delineation is necessary for the establishment of service quality and safety. Further research should also quantify the return on investment of nursing-led QI and its role in emerging technologies like artificial intelligence.
Copyright (c) 2025 Muthiba Khalifa Almutairi, Abdullatif Yousef Ahmed Almuqahwi, Amaal Issa Dahlan, Rabab Gida Alamri, Hind Yousef Ahmad Albutyan, Latifah Aiyedh Almutairi, Duaa Saleh Saad Alhamood, Khaled Mohammed Alsahli, Aisha Alsheta, Hamzah Mohammed Ahmed Buayti https://creativecommons.org/licenses/by/4.0
Optimizing the Healthcare Team: A Systematic Review of Role Delegation and Task Sharing Between Nurses and Secretarial Staff in General Medicine Practices
Background: General medicine practices are facing rising clinical complexity, administrative tasks, and patient demand, which require the establishment of innovative team-based care models to optimize efficiency and staff well-being. Aim: The systematic review uses 2015-2025 literature to report on models, outcomes, facilitators, and barriers to role delegation and task sharing between secretarial and nursing staff in general medicine. Methods: Systematic database searching was used through databases like PubMed, CINAHL, and Scopus. Eligible studies were those that evaluated interventions of task delegation or role sharing between administrative and nursing staff in primary care settings and reported relevant outcomes. Results: Examples of prominent models mentioned are the Chronic Care Model (CCM), teamlets, and protocol-based task redistribution. There is evidence that effective delegation significantly improves physician and staff burnout, team satisfaction, and functional effectiveness (e.g., reduced wait times, better panel management). Appropriately delegated work can maintain or even improve quality measures for chronic disease and preventive care. Significant obstacles include preservation of professional role, regulatory constraints, and inadequate training, while effective leadership, co-designed workflows, and effective communication are key facilitators. Conclusion: Intentional redesign of nurse-secretarial staff positions is a crucial strategy for creating a high-performing, sustainable primary care system, but success depends on surmounting implementation issues.
Copyright (c) 2025 Abdullah Ali M Alzahrani, Ahlam Mohammed Mashnafi, Mohammed Hebah Yahya Badwi, Tahani Mohammed Algammdi, Reem Salman Al Otaibi, Abdulmajeed Muneer Alotaibi, Hassan Awaji Mohammad Hakimi, Ahlam Mohammed Mashnafi, Rahaf Murdhi Alanazi https://creativecommons.org/licenses/by/4.0
Optimizing Outcomes in Lupus Nephritis Through Interdisciplinary Collaboration: The Intersection of Nursing, Family Medicine, Laboratory Science, and Medical Record Management
Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by immune complex deposition and multi-organ inflammation. Lupus nephritis (LN), a severe renal manifestation, is a leading cause of morbidity and mortality in SLE patients, with a significant risk of progression to end-stage renal disease (ESRD) if not managed promptly. Aim: This article synthesizes the complex etiology, pathophysiology, and management of LN, with an implicit aim to underscore the necessity of a multidisciplinary, collaborative approach to optimize patient outcomes through early detection, precise diagnosis, and personalized treatment. Methods: The review consolidates current medical literature on LN, detailing its pathogenesis involving genetic predisposition, environmental triggers, and immune dysregulation. It emphasizes the critical role of renal biopsy for histopathological classification (ISN/RPS system) and evaluation of activity/chronicity indices. The management framework is analyzed, outlining evidence-based protocols for induction and maintenance immunosuppressive therapy, risk-factor modification, and the integration of novel biologic agents. Results: LN prognosis is highly dependent on timely intervention guided by histologic class. Proliferative forms (Classes III/IV) carry the poorest renal outcomes without aggressive treatment. Advances in therapy, including mycophenolate mofetil, belimumab, and voclosporin, have improved remission rates and enabled steroid-sparing strategies. However, outcomes are significantly influenced by factors such as ethnicity, access to care, and adherence to long-term maintenance therapy. Conclusion: Effective management of LN requires an interdisciplinary model integrating rheumatology, nephrology, nursing, primary care, and laboratory science. This collaborative framework ensures vigilant surveillance, biopsy-informed treatment decisions, aggressive comorbidity management, and comprehensive patient education, ultimately leading to preserved renal function and improved quality of life.
Copyright (c) 2025 Shams Yousef Alamri, Shroq Hadi Hassan Hamzi, Majed Shwiman Alshwiman, Zahi Mohammed Alqarni, Samiah Saleem Alharbi, Ahlam Khalaf Daher Albalawi, Ahmad Khalaf Thaher Al-Balwi, Hanan Ahmed Dagriri, Maqbulah Ali Albalawi, Shroq Hadi Hassan Hamzi https://creativecommons.org/licenses/by/4.0
Optimizing Inferior Alveolar Nerve Block: An Interdisciplinary Approach between Dentistry and Anesthesiology
Background: The Inferior Alveolar Nerve Block (IANB) is a fundamental regional anesthesia technique in dentistry, essential for procedures on the mandibular teeth and soft tissues. Despite its widespread use, it has a reported failure rate of 15-20%, often due to anatomical complexity and technical inaccuracies in locating the mandibular foramen. Aim: This article aims to synthesize the principles of IANB administration, advocating for an interdisciplinary approach between dentistry and anesthesiology to optimize its success, enhance patient safety, and manage complications effectively. Methods: A comprehensive review of the IANB technique is presented, covering the relevant anatomy of the mandibular nerve and foramen, indications, contraindications, and necessary equipment. The analysis details the conventional injection technique, evidence-based modifications (e.g., Thangavelu, Gow-Gates), and the role of technology like Computer-Controlled Local Anesthetic Delivery (CCLAD) systems. Potential local, neurological, and systemic complications and their management are also examined. Results: Mastery of the IANB requires a deep understanding of anatomical landmarks and their variations. Techniques guided by consistent bony landmarks, such as the internal oblique ridge, may improve success rates. Furthermore, a coordinated, interprofessional team approach—involving dentists, physicians, nurses, and pharmacists—is critical for pre-procedural risk assessment, safe administration, and managing emergencies like local anesthetic systemic toxicity (LAST). Conclusion: The IANB remains a cornerstone of dental practice. Its optimization hinges on anatomical expertise, technical precision, and a collaborative healthcare model that prioritizes patient-specific care and safety.
Copyright (c) 2025 Ershad Hussein Ali Alnemi, Mohammed Ahmed Asiri, Mohammed Mashraqi, Abdulrahman Samir Khateiri, Ruwayda Hamed Yahya Sughayyir , Abdulaziz Abdullah Alahmari, Wahaj Awadh Matar Alsaadi, May Ayed Alanazi, Hanan Salah Almutairi, Abdallh Badr Obaid Almutiri, Ershad Hussein Ali Alnemi, Eid Mohammad Ahmed Hadi, Haifa Suliman Aljohani , Noor Naif Alaswad Alazmi https://creativecommons.org/licenses/by/4.0
Interdisciplinary Perspectives on Preterm Labor: Clinical Management, Epidemiological Trends, and Emergency Nursing Interventions in Maternal Health
Background: Preterm labor (PTL), defined as regular uterine contractions with cervical change between 20 and 37 weeks' gestation, is a leading cause of neonatal morbidity and mortality worldwide. It is a complex syndrome driven by multiple etiologies, including infection, inflammation, uterine overdistension, and vascular pathology. Aim: This article synthesizes interdisciplinary perspectives on PTL, aiming to clarify its definition, pathophysiology, and evidence-based management. It emphasizes a risk-stratified approach to diagnosis and treatment to optimize neonatal outcomes while avoiding unnecessary interventions. Methods: A comprehensive review is presented, covering the epidemiology, multifactorial pathophysiology, and clinical evaluation of PTL. Diagnostic methods include history, physical exam, transvaginal ultrasound for cervical length, and biomarkers like fetal fibronectin. Management strategies are analyzed, focusing on the gestational age-based application of antenatal corticosteroids, tocolysis, magnesium sulfate for neuroprotection, and Group B Streptococcus prophylaxis. Results: Accurate diagnosis remains challenging, as most symptomatic patients do not deliver imminently. Risk stratification using cervical length and biomarker testing is crucial. Time-sensitive interventions, particularly antenatal corticosteroids and magnesium sulfate, significantly improve neonatal outcomes when appropriately targeted to high-risk patients between 24 and 34 weeks gestation. Conclusion: Effective management of PTL requires an integrated, interdisciplinary approach. Mastery of diagnostic criteria, risk stratification, and the timely administration of evidence-based therapies is essential to reduce the global burden of prematurity.
Copyright (c) 2025 Mousa Ali Mousa Ayashi, Rashid Marde Bakhet Al‏Dosari, Mashael Abdullah Refaie , Mousa Ali Mousa Ayashi, Faisal Lafi Al-Mutairi, Mohammed Ali Mohammed Awaf, Ahmed Ali Awaf, Mohammed Ali Mohammed Awaf, Hamad Ibrahim Hamad Alghareeb, Nemah Ahmed Rajhi , ‏Sumayyah Saud Tuaysan Alanazi https://creativecommons.org/licenses/by/4.0
Integrative Nursing and Optical Approaches to Vision Rehabilitation: Best Practices in Prescribing Corrective Lenses for Pseudophakic Patients
Background: Cataract surgery, one of the most common procedures worldwide, replaces the opacified crystalline lens with an intraocular lens (IOL), creating a pseudophakic eye. Despite advanced IOL technology, a significant proportion of patients require spectacle correction postoperatively to achieve optimal visual acuity and comfort for specific tasks, making precise refraction and spectacle prescribing a critical component of visual rehabilitation. Aim: This article aims to outline best practices for prescribing corrective lenses for pseudophakic patients, integrating surgical outcomes with patient-specific visual needs. It emphasizes an interdisciplinary approach to navigate the unique challenges of pseudophakia, including managing residual refractive error, anisometropia between staged surgeries, and the specific demands of premium IOLs. Methods: A comprehensive review of the prescribing process is presented, covering the timing of postoperative refraction, the indications for spectacles, and the necessary diagnostic equipment (e.g., autorefractor, phoropter, corneal topographer). The analysis details how to tailor prescriptions based on IOL type (monofocal, toric, multifocal, EDOF) and patient lifestyle, including the selection of progressive addition lenses, occupational designs, and specialized coatings. Results: Successful visual rehabilitation depends on accurate refraction performed after ocular stabilization (typically 3-4 weeks post-surgery). Key to patient satisfaction is managing interim anisometropia, correcting even small residual errors, and prescribing task-specific eyewear. A coordinated effort between ophthalmologists, optometrists, and opticians is essential to translate surgical results into functional, comfortable vision. Conclusion: Prescribing spectacles for pseudophakic patients is a nuanced, rehabilitative process rather than a simple transaction. A patient-centered, interdisciplinary approach ensures that spectacles effectively complement the surgical outcome, maximizing visual quality, binocular comfort, and long-term satisfaction.
Copyright (c) 2025 Dina Idarous Misky, Nourah Abdullah Alowais , Fawaz Nasser Alhuwaymil, Fatimah Fahad Alnasser, Reem Hilal Break Al-Otaibi, Iyman Ahmed Mohamad Harash, Mona Dakheil Saad Albalawi , Hadi Mohmmed Mohsen Hagawi , Abdulrahman Saad Bijad Alsubaie, Maryam Essa Ayyashi, Shouhrah Saad Mohumad Alshoumrani, Abdulrahman Mohsen Siddiq Tubayqi, Saad Abdulaziz Alrabiah https://creativecommons.org/licenses/by/4.0
Assessment of Knowledge and Awareness of First Aid Among School Teachers: An Updated Review for Paramedics, Emergency Professionals, and Nursing
Education about first aid amongst school teachers is an important aspect of student safety and efficient response to emergency situations in school. The first to react in case of any accidents or sudden health cases in schools are the teachers, thus their quick response is capable of saving lives and avoiding complications. This study determines the levels of knowledge, awareness, and preparedness of teachers at schools concerning first aid procedures. It investigates the issues in teaching experience, exposure to training and confidence levels and institutional support to advance first aid education. The surveys and literature reviews were used to obtain data, which helped reveal the current gaps and the area of improvement. The results indicate the need to incorporate systematic first aid training into teacher education programs, periodically updating the refresher courses, and improving policies on emergency preparedness in schools. Increasing the first aid competence of teachers is not only helping to create safer schools but can also help establish a culture of responsibility, awareness and health among the educational facilities.
Copyright (c) 2025 Mohammed Ayad Al Harbi, Majed Mirzaq Matar Almutairi, Khawlah Mohammed Judayba , Taghred Ayad Alshalwi, Reem Sunaytan Alotaibi, Ishraq Siddiq Hakami , Mohammed Ali Mohammed Awaf, Ahmed Ali Awaf, Abdulrahman Mohsen Siddiq Tubayqi, Khaled Mohammed Alsahli, Nabila Bakur Alhawsawi https://creativecommons.org/licenses/by/4.0
Mass Spectrometry in the Clinical Laboratory: Beyond Toxicology to Endocrinology and Microbiology
Background: The clinical laboratory has witnessed a paradigm shift with the introduction of mass spectrometry (MS) into its activities, extending its role way beyond the traditional field of toxicology. Aim: This review comprehensively discusses the revolutionizing impact of tandem mass spectrometry (MS/MS) and matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) MS on the diagnosis and management of human disease, particularly in endocrinology and microbiology. Methods: Synthesis of concepts, applications, and relative advantages of these MS methods from the current literature between 2015 and 2024 was reviewed. Results: Liquid chromatography-tandem mass spectrometry (LC-MS/MS) emerged as the gold standard in endocrinology with improved specificity for steroid, thyroid hormone, and vitamin measurement, thereby enabling accurate diagnosis of complex disorders. Meanwhile, MALDI-TOF MS has revolutionized clinical microbiology by providing quick, accurate, and cost-effective microbial identification, with an appreciable shortening of the time to effective antimicrobial therapy. Further, MS/MS remains the basis of newborn screening for congenital errors of metabolism. Despite challenges like standardization and cost, newer directions like mass spectrometry imaging and ambient ionization techniques promise further advancements. Conclusion: The findings verify that MS/MS and MALDI-TOF MS lead the path of the modern clinical laboratory's commitment to deliver precise, individualized, and prompt patient treatment.
Copyright (c) 2025 Ali Saeed Abdullah Alzahrani, Hani Awied Aied Alharbi, Ali Abdullah Mohammed Alsaab, Yasir Ali Muhammad Al-Zahrani, Emad Ali Muhsin Alattas, Ahmed Abdullah Orepi, Ali Abdullah Alzahrani, Majed Abdulrahman Alrashidi, Mansour Butayhan Al Mabdi, Ali Ahmed Alomari Alzhrani https://creativecommons.org/licenses/by/4.0
Lactic Acidosis: Pathophysiology, Diagnosis, and Nursing Management
Background: Lactic acidosis is a critical metabolic condition characterized by the systemic accumulation of lactate, resulting from an imbalance between its production and clearance. It is commonly classified into Type A, caused by tissue hypoperfusion and hypoxia (e.g., shock), and Type B, associated with underlying diseases, toxins, or mitochondrial dysfunction. It is a frequent finding in critically ill patients and is strongly linked to high mortality rates. Aim: This article aims to comprehensively review the pathophysiology, diagnosis, and management of lactic acidosis, with a specific focus on the integral role of nursing in early recognition, monitoring, and coordinating interdisciplinary care to improve patient outcomes. Methods: The article synthesizes current medical knowledge on lactic acidosis, detailing its physiological mechanisms, risk factors, and diagnostic criteria. It outlines systematic approaches for assessment, evaluation (including arterial blood gas and anion gap analysis), and evidence-based medical and nursing interventions. Results: Effective management hinges on rapid identification and treatment of the underlying cause, such as infection source control in sepsis. Medical management involves goal-directed fluid resuscitation, vasopressor support, and optimizing oxygen delivery. Serial lactate monitoring and clinical assessment of perfusion are crucial for evaluating treatment efficacy. Nursing management is pivotal in executing these interventions, providing continuous monitoring, and ensuring coordinated, patient-centered care. Conclusion: Lactic acidosis is a life-threatening condition requiring a prompt, systematic, and interdisciplinary approach. Successful outcomes depend on correcting the underlying cause, restoring tissue perfusion, and meticulous supportive care, with nurses playing a central role in monitoring, intervention, and care coordination.
Copyright (c) 2025 Sawsan Hussain Ali Alsaleh, Maryam Hussin Habib Alabood, Laila Eissa Abdullah Alatwan, Latifah Farhan Ahmed AlQasim, Eman Ali Khalifah Al Farhan, Sukinah Saleh Jasem Aljubran, Aisha Adel Abdulaziz Alsaqer, Hajer Saleh Yousef Alowaidh, Amal Rashed Fahed Alkhammash, Hind Nahar Hmad Alhagriaf, Amerah Saleh Ibrahim Aljamaan, Amenah Nasser Abdullah AlnefIly https://creativecommons.org/licenses/by/4.0
Optimizing Chronic Insomnia Care Through Pharmacist Intervention, Laboratory Evaluation, and Administrative Coordination
Background: Chronic insomnia is a highly prevalent sleep disorder characterized by persistent difficulty initiating or maintaining sleep, leading to significant daytime impairment. It is a major public health concern with strong links to psychiatric and medical comorbidities, including depression, anxiety, and cardiovascular disease, and is driven by a complex pathophysiology involving hyperarousal and dysregulation of sleep-wake circuits. Aim: This article aims to outline a comprehensive, interprofessional framework for managing chronic insomnia, emphasizing the synergistic roles of pharmacists, laboratory services, and health administrators in optimizing patient care from diagnosis through long-term treatment. Methods: The proposed model integrates evidence-based interventions. First-line treatment is Cognitive Behavioral Therapy for Insomnia (CBT-I). Pharmacological options, including GABAergic agents, dual orexin receptor antagonists, and melatonin agonists, are used adjunctively. The framework leverages pharmacists for medication management and deprescribing, laboratory services for identifying underlying medical causes, and health administrators for implementing system-wide protocols and digital health solutions like internet-delivered CBT-I (iCBT-I). Results: This collaborative approach facilitates accurate diagnosis, ensures guideline-concordant treatment, and improves patient adherence. It leads to reduced reliance on long-term pharmacotherapy, better management of comorbid conditions, and more efficient use of healthcare resources through streamlined workflows and improved access to first-line behavioral therapies. Conclusion: Effective management of chronic insomnia requires a unified, systems-based strategy. By integrating the distinct expertise of clinicians, pharmacists, laboratory professionals, and administrators, healthcare systems can shift from a reactive, medication-focused model to a proactive, patient-centered approach that addresses the root causes of insomnia and improves long-term outcomes.
Copyright (c) 2025 Ali Nasser Shammakhi, Mohammed Ali Alhazmi, Ahmed Mohammad Mrair, Yahya Mohammed Dahhas, Adel Hamad Khardli, Abdallah Ali Hakami, Faisal Hassan Al-Harbi, Abualqasim Nasser Zoagan, Khaled mossa mashi, Nasser Mohemmed Mjrshi, Ahmed Jibril A Sherwani, Norah Hinbas Ali Naji, Mousa M Ageeli https://creativecommons.org/licenses/by/4.0
The Impact of Red Crescent First Aid Awareness Campaigns on Improving Emergency Preparedness Among Vulnerable Groups: A Systematic Review for Emergency Professionals and Nursing
Background: Vulnerable groups are disproportionately vulnerable to the dangers of emergencies. The International Federation of Red Cross and Red Crescent Societies (IFRC) and National Societies use first aid awareness campaigns as a central public health intervention to strengthen community resilience and emergency preparedness from the ground level. Aim: The present review seeks to critically assess the effect of Red Crescent first aid awareness campaigns on enhancing emergency readiness among vulnerable populations around the world, drawing on evidence from the past decade. Methods: A systematic synthesis of peer-reviewed research (2015-2024), IFRC publications, and applicable case studies was used to explore the effectiveness and operational challenges of such campaigns. Results: The results always verify that such campaigns significantly improve immediate first aid knowledge and capabilities among the respondents. They also inspire positive behavioral intentions, improve self-efficacy, and foster a broader culture of safety and self-responsibility. The effectiveness of campaigns is hugely moderated by profound socioeconomic obstacles, cultural settings, and logistical limitations in targeting the most vulnerable groups. Conclusions: Red Crescent first aid campaigns are an effective and cost-saving method of enhancing community emergency preparedness. Their strategic integration into public health, disaster risk reduction (DRR), and universal health coverage (UHC) plans is strongly recommended. Next steps must be innovative, context-specific, and longitudinally focused to maximize impact and overcome current impediments.
Copyright (c) 2025 Ahmed Mofareh Alanazi, Swelem Nafea Aqla Alanzy, Saleh Jaber Salamah Alanzi, Mariam Abdullah Mohammed Hadadi, Maryam Naif Alaswad Aloudah, Hosam Hasan Alzhrani , Nowair Al-Homaidi Hassan Al-Qahtani, Mohammed Yahya Abdu Sofyani, Yousef Ramadan Fayadh Al-Enezi https://creativecommons.org/licenses/by/4.0
Cybersecurity Threats in Medical Devices: An Examination of Nursing Science, Role, and Patient Safety Interventions
Background: The integration of networked medical devices with healthcare, while positive, has presented significant cybersecurity threats. These risks compromise device operation, patient data, and safety. Nurses, as heavy users of devices, are a critical but unaddressed line of protection against such threats. Aim: The aim of this review is to synthesize literature between 2015-2024 to talk about cybersecurity threats in medical devices, assess nursing knowledge and preparedness, present evolving nursing roles, and examine strengthened patient safety practices. Methods: A narrative review was conducted by conducting a systematic search on major scholarly databases (PubMed, CINAHL, Scopus) for English-language articles released during the time period 2015-2024. Keywords used were medical devices, cybersecurity, nursing, and patient safety. Results: The review identifies an enormous gap in formal education related to cybersecurity among nurses, rendering them unprepared to recognize or handle threats. At the same time, nursing duties are informally broadened to incorporate cyber-hygiene activities. The findings bring attention to the imperative necessity of formalizing the role of a nurse as a frontline warrior against threats. Conclusion: A formal integration of cybersecurity into nursing practice is urgently needed. This can be achieved through formalized educational frameworks, clear practice guidelines, and improved interdisciplinary cooperation in order to ensure patient safety in the technology era.
Copyright (c) 2025 Abdulrahman abdullah saif Alsahli, Seham suleman hamd Alsaeed, Fuad Moraia Mohammed Hakami, Rawabi Hamdan Muklif, Tagreead Gaman Al shrari, Wssmiah Fahad ALsaad, Ahlam ali alnami, Samaria Ali Ali Mahnasi, Kathiyh Jaman ALyami, Aisha Hafiz Ibrahim, Nesreen Hafiz Ibrahim, Eman Hafiz Ibrahim https://creativecommons.org/licenses/by/4.0
Osteoporosis in Females: An Interdisciplinary Approach Integrating Nursing Care, Family Support, Social Determinants, Physiotherapists, and Laboratory Evaluation.
Background: Osteoporosis is a systemic skeletal disease characterized by reduced bone mineral density (BMD) and microarchitectural deterioration, leading to increased fragility and fracture risk. It represents a major global public health challenge, disproportionately affecting postmenopausal females due to the abrupt decline in estrogen, which accelerates bone resorption. The condition is often asymptomatic until a fragility fracture occurs, resulting in significant pain, disability, mortality, and societal cost. Aim: This article synthesizes the etiology, epidemiology, and pathophysiology of osteoporosis in females and advocates for an interdisciplinary management approach. It aims to outline comprehensive evaluation strategies and evidence-based treatments, integrating the roles of nursing, family medicine, laboratory services, and social care to close pervasive screening and treatment gaps. Methods: A comprehensive review is presented, covering the disease's historical context, pathophysiological mechanisms (including the RANKL/RANK/OPG axis), and diagnostic criteria using dual-energy X-ray absorptiometry (DXA). Risk assessment tools like FRAX and laboratory evaluations for secondary causes are detailed. Management strategies, including pharmacological and non-pharmacological interventions, are systematically reviewed. Results: Osteoporosis management requires a multifaceted strategy. First-line pharmacotherapy includes bisphosphonates and denosumab, while anabolic agents (e.g., teriparatide, romosozumab) are reserved for very high-risk patients. Non-pharmacological foundations encompass calcium, vitamin D, weight-bearing exercise, and fall prevention. Successful outcomes depend on coordinated, interprofessional care to improve diagnosis, treatment adherence, and persistence. Conclusion: A proactive, interdisciplinary model is essential to transform osteoporosis from a "silent epidemic" into a managed chronic condition, thereby reducing the immense personal and economic burden of fragility fractures.
Copyright (c) 2025 Nashban Mohammed Hakamy, Dhaifallah Jaber Hassan Almalki, Salma Yahya Darraj, Mazen Abdulrahman Mohammed Alamer, Amirah Omair Mohammed Madkhali, Laila Mohammed Awaji Ogdi, Hayat Mohammed Aref, Salma Mohammed Aref, Rawan Mohammed Farhan, Ali Ibrahim qasem Al darb https://creativecommons.org/licenses/by/4.0
The Role of Optometry-Nursing Teams in Closing the Gap in Geriatric Care: A Scoping Review
Background: The world's population is rapidly aging, and an unprecedented prevalence of chronic and comorbid conditions threatens functional independence and quality of life. Optometry and nursing are often considered discrete practice disciplines, but their potential contribution to collaborative and integrated care for addressing many of these gaps remains underexplored. Aim: The goal of this scoping review was to map the existing literature regarding interventions and care models that incorporate the combined expertise of both optometry and nursing in the management of key geriatric syndromes. Methods: A systematic search of electronic databases, namely, PubMed, CINAHL, Scopus, and Web of Science, was made for literature between 2014 and 2025. Results: The review found a nascent but promising body of evidence. The results of the study point to three specific areas of collaboration: 1) Falls Prevention, where the nurse conducts a risk assessment and medication review in consultation with optometrist on refractive corrections; 2) Age-related Macular Degeneration (AMD) and vision impairment support where optometrist does the diagnosis and treatment, while nurses would provide psychosocial support and coaching; and 3) early signs of cognitive decline where optometrist can assess visual biomakers related to systemic health by nurses. Conclusion: Optometry-nursing teams represent a powerful, patient-centered model for closing critical gaps in geriatric care. The current review aimed to summarize core components of successful collaborations and to present a conceptual framework for integration. Future research should focus on high-quality, quantitative trials to confirm efficacy and on developing standardized protocols for implementation.
Copyright (c) 2025 Abdulhadi Abdullah Ali Alshawakir, Bander Saqer Alanazi, Amnah Hassan Ahmed Asuni, Enter Bakr Takroni, Abdullah Amer B Aldosari, Nawdh Mutair Almajdi, Kamlah Saad Alshehri , Amal Abdullah Makrami, Mutaib Abdulrahman Mukhlid Alotaibi, Al Anoud Abdullah Al Qarni, Noha Abdullah Alanzei, Aisha Hamed Hamoud Aloseimi https://creativecommons.org/licenses/by/4.0
Interdisciplinary Approaches to Managing Bariatric Surgery Complications: The Collaborative Roles of Nursing, Physical Therapy, and Nutrition in Postoperative Recovery and Long-Term Outcomes.
Background: Bariatric surgery is a highly effective intervention for morbid obesity and its associated comorbidities. However, the procedures carry a significant risk of both immediate and long-term complications, including anastomotic leaks, nutritional deficiencies, and dumping syndrome, which can impact patient outcomes and recovery. Aim: This article aims to delineate a comprehensive, interdisciplinary framework for managing bariatric surgery complications, emphasizing the critical, collaborative roles of nursing, physical therapy, and nutrition services in optimizing postoperative recovery and ensuring long-term success. Methods: The review synthesizes a multidisciplinary care model. Key methods include proactive nursing assessment for early complication detection, structured physical therapy to enhance mobility and prevent thromboembolism, and detailed nutritional counseling and monitoring to prevent and correct micronutrient deficiencies. This integrated approach spans from preoperative education to lifelong follow-up. Results: An interprofessional team approach leads to improved patient outcomes by enabling early recognition and management of surgical complications, reducing recovery times, and enhancing adherence to dietary and supplement regimens. This coordination mitigates risks such as vitamin deficiencies, weight regain, and psychological distress, thereby supporting durable weight loss and metabolic health. Conclusion: The long-term success of bariatric surgery is fundamentally dependent on sustained, collaborative care. By integrating the expertise of surgeons, nurses, physical therapists, and dietitians into a cohesive team, healthcare systems can effectively manage complications, support patient adaptation, and maximize the profound benefits of surgical intervention for morbid obesity.
Copyright (c) 2025 Mohammed Julaymid Almutairi, Alotalbl Masoud Masaad S, Mohammed Salem Almotairi, Ali Hussain Alnowiser, Ftma Abdullah Alhejji, Ahmed Abdullah Mohammad Muafa , Jabeer Abdullah Sadig , Abdulmujib Ali Kaabi, Abada Awaji Hakami, Mohammed Khalid Albarqawi , Albatool Abdulrhman Alanazi, Aisha Mahmood Maggadmi https://creativecommons.org/licenses/by/4.0
The nursing practice standard of professional ethics is the basis of caring, safe and responsible practices with patients. The ethics helps nurses in making decisions, acting, and dealing with patients, families, and other healthcare teams ethically. This paper discusses professional ethics and its significance in nursing, its historical formation, and the role of major principles of ethics, namely, autonomy, beneficence, nonmaleficence, and justice. It also points out the importance of confidentiality, informed consent and telling the truth in nursing practice. Moreover, the ethical dilemmas encountered by nurses most often, the effects of technology and digitalizatioln on the ethics, and the influence of leadership on the development of the ethical culture in healthcare facilities is discussed. Ethical behavior promotion strategies and future trends towards attaining future ethical excellence are also provided. The paper notes that ethical integrity is not a professional responsibility but an ethical obligation to promote human dignity, trust and the utmost standards of care in a continuously evolving healthcare setting.
Copyright (c) 2025 Naseem Mohammed Ahmed Jawhali, Faisal Khalid A Zakri, Nouruldeen Mohammed Jabril Alsabi, Amsha Mohammed Al Harbi, Adel Maqbul Mutlaq Alsharari, Mahal Bandar Alotaibi, Amal Ibrahim Al -Mamlouh, Zahra Ali Mohsin Alnakhli, Madhawi Abdulaziz Alsulayli, Latifah Aiyedh Almutairi, Fatimah Ayidh Almutairi, Alkohzama Mohseen Saif Albashe, Dalal Rasheed Altawyan https://creativecommons.org/licenses/by/4.0
Management of Penetrating Abdominal Trauma in the Emergency Department
Background: Penetrating abdominal trauma is a critical, high-stakes emergency and a leading cause of trauma-related mortality, particularly among young males in urban settings. It involves a breach of the abdominal wall by objects such as knives or bullets, posing immediate risks of life-threatening hemorrhage and hollow viscus perforation. Aim: This article synthesizes the current principles for managing penetrating abdominal trauma in the emergency department, focusing on rapid triage, accurate evaluation, and decisive intervention to control hemorrhage and contamination, thereby reducing preventable deaths. Methods: The review outlines a protocol-driven approach based on Advanced Trauma Life Support (ATLS) principles. Key diagnostic methods include the Focused Assessment with Sonography for Trauma (FAST) for unstable patients and computed tomography (CT) with intravenous contrast for stable patients to identify injury tracts and organ damage. Management pathways are stratified by patient physiology. Results: Hemodynamically unstable patients require immediate surgical exploration. For stable patients, Selective Non-Operative Management (SNOM) is increasingly viable, supported by serial examinations and imaging. Minimally invasive techniques like laparoscopy and endovascular interventions (e.g., REBOA, angioembolization) have expanded treatment options, reduced the rate of non-therapeutic laparotomies and improving outcomes. Conclusion: Successful management hinges on a disciplined, algorithm-based approach that integrates rapid assessment, judicious use of imaging, and a spectrum of interventions from observation to damage-control surgery. This systematic strategy is essential for optimizing survival and minimizing complications.
Copyright (c) 2025 Naif Qutaysh Alruwaili, Khaled Fayez Zaal Alanazi, Bader Abd Helal Alhazml, Horan Ali Alhazmi, Ali Eid Ali Altwarish, Faisal Ayidh Abdullah Alanazi, Sultan Fayadh Alanazi, Lutfi Qayyadh Mutairan Alhazmi, Sultan Dalish Alanazi, Tariq Mofareh Alanazi, Sami Tirad K Alruwaili, Naif Abdullah Alanazi, Raed Madallah Alanazi, Aed Salem Alhazmi https://creativecommons.org/licenses/by/4.0
Bridging Family Medicine, Nursing, and Laboratory Practice in the Diagnosis and Care of Food Allergies
Background: Food allergies represent a significant and growing public health challenge with substantial clinical, psychosocial, and economic impacts. The etiology is multifactorial, involving genetic susceptibility, environmental exposures, and immune system dysregulation that leads to a failure of oral tolerance. Diagnosis and management require a coordinated, multidisciplinary approach. Aim: This article aims to synthesize the comprehensive landscape of food allergies, detailing their pathophysiology, epidemiology, and the essential, integrated roles of family medicine, nursing, and laboratory practice in achieving optimal patient outcomes through precise diagnosis, effective management, and robust patient education. Methods: The review consolidates evidence on the immunologic mechanisms (IgE-mediated and non-IgE-mediated), diagnostic evaluations (including skin prick testing, serum-specific IgE, and the gold-standard oral food challenge), and management strategies. It emphasizes a collaborative care model spanning primary care, specialized nursing, and diagnostic laboratories. Results: Effective management hinges on strict dietary avoidance, emergency preparedness with epinephrine, and ongoing patient education. Prognosis varies, with many childhood allergies (e.g., milk, egg) often being outgrown, while others (e.g., peanut, shellfish) typically persist. Emerging treatments like immunotherapy and biologics (e.g., omalizumab) offer promise for desensitization. Complications range from acute anaphylaxis to chronic nutritional and psychosocial burdens. Conclusion: An interprofessional team model is critical for improving the safety and quality of life for individuals with food allergies. This model integrates prevention, accurate diagnosis, personalized management, and continuous education to navigate the complexities of the condition.
Copyright (c) 2025 Asaad Ali Mohammed Habbash, Meshari Zayed Almutairi, Fahad Mousa Wasili, Manal Saud Alharbi , Majed Abdulrahman Alrashidi, Mansour Butayhan Al Mabdi, Ali Ahmed Alomari Alzhrani, Yahya Fathe Adawie, Mashael Musnad Odhayb Alanazi, Abrar Mohammed Alanzl https://creativecommons.org/licenses/by/4.0