Shuruq Alkhalaf, Nadeef Alqahtani, Amani AbuAlnaja, Saud Alhassoun, Alexandra Alkhatir, Dania Al-Jaroudi
Introduction: This study assessed the prevalence of congenital malformation among neonates born after using progesterone for luteal support in patients undergoing IVF and ICSI cycles. Methods: This retrospective cohort study was conducted in the Reproductive Endocrinology and Infertility Department of a tertiary hospital. Two groups were compared: one group received only Cyclogest or Crinone gel, and the other group received a combination of Cyclogest or Crinone gel with Proluton Depot injection Results: A total of 91 patients were included, all of whom took progesterone during their IVF and ICSI cycles. The minimum age of the participants was 21, and the maximum was 41. 16.5% (n=15) patients who received progesterone for luteal support during their IVF and ICSI cycles gave birth to infants with congenital malformation, while 76 (83.5%) did not. The most commonly observed congenital malformation was patent ductus arteriosus, observed in 5 cases (5.49%), followed by delayed speech observed in 2 (2.2%). Brachydactyly, Down syndrome, autism spectrum disorder, and a number of other conditions were observed at a rate of 1.1%. Ultimately, no significant association was found between the two groups and the incidence of congenital malformations (p = 0.121). Conclusion: Our review indicates that the incidence of congenital anomalies was similar across the different treatment groups.
{"title":"Prevalence of congenital malformation among neonates born after the use of progesterone for luteal support during IVF and ICSI cycles","authors":"Shuruq Alkhalaf, Nadeef Alqahtani, Amani AbuAlnaja, Saud Alhassoun, Alexandra Alkhatir, Dania Al-Jaroudi","doi":"10.52609/jmlph.v3i3.92","DOIUrl":"https://doi.org/10.52609/jmlph.v3i3.92","url":null,"abstract":"Introduction: This study assessed the prevalence of congenital malformation among neonates born after using progesterone for luteal support in patients undergoing IVF and ICSI cycles. Methods: This retrospective cohort study was conducted in the Reproductive Endocrinology and Infertility Department of a tertiary hospital. Two groups were compared: one group received only Cyclogest or Crinone gel, and the other group received a combination of Cyclogest or Crinone gel with Proluton Depot injection Results: A total of 91 patients were included, all of whom took progesterone during their IVF and ICSI cycles. The minimum age of the participants was 21, and the maximum was 41. 16.5% (n=15) patients who received progesterone for luteal support during their IVF and ICSI cycles gave birth to infants with congenital malformation, while 76 (83.5%) did not. The most commonly observed congenital malformation was patent ductus arteriosus, observed in 5 cases (5.49%), followed by delayed speech observed in 2 (2.2%). Brachydactyly, Down syndrome, autism spectrum disorder, and a number of other conditions were observed at a rate of 1.1%. Ultimately, no significant association was found between the two groups and the incidence of congenital malformations (p = 0.121). Conclusion: Our review indicates that the incidence of congenital anomalies was similar across the different treatment groups.","PeriodicalId":498683,"journal":{"name":"The journal of medicine, law and public health","volume":"22 11","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135036911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ahmed Alwosibei, Hanan Alqurashi, Mohammed Alghazwi
Background: In emergency and critical care settings, can a venous blood gas analysis improve clinical decision-making and patient outcomes? Methods: This is a cross-sectional study, conducted between January and June 2022 at a tertiary hospital in Saudi Arabia. Results: A total of 100 patients were included, using a convenience sample technique. Their mean age was 54 years, and theirmain chief complaints were shortness of breath (30%), abdominal pain (15%), and altered level of consciousness (14%). The venous blood gas (VBG) result was abnormal in 86 patients, and predicted the need for early intervention in 69 patients (69.7%). A significant association was found between patients requiring early intervention and those with an abnormal VBG (p=0.0005). Furthermore, the VBG results changed the Canadian Triage and Acuity Scale (CTAS) level in 32 patients (33.68%). A logistic regression analysis revealed that pre-testing factors such as age, gender, comorbidities, and chief complaints were not predictors of VBG results, the need for early intervention, or altered CTAS level. Conclusion: Our study concludes that VBG analysis can play an important role in patient triage in the emergency department (ED), allowing for earlier intervention and potentially improving outcomes.
{"title":"Role of Venous Blood Gase (VBG) Analysis in Patient Triage in the Adult Emergency Department","authors":"Ahmed Alwosibei, Hanan Alqurashi, Mohammed Alghazwi","doi":"10.52609/jmlph.v3i3.83","DOIUrl":"https://doi.org/10.52609/jmlph.v3i3.83","url":null,"abstract":"Background: In emergency and critical care settings, can a venous blood gas analysis improve clinical decision-making and patient outcomes? Methods: This is a cross-sectional study, conducted between January and June 2022 at a tertiary hospital in Saudi Arabia. Results: A total of 100 patients were included, using a convenience sample technique. Their mean age was 54 years, and theirmain chief complaints were shortness of breath (30%), abdominal pain (15%), and altered level of consciousness (14%). The venous blood gas (VBG) result was abnormal in 86 patients, and predicted the need for early intervention in 69 patients (69.7%). A significant association was found between patients requiring early intervention and those with an abnormal VBG (p=0.0005). Furthermore, the VBG results changed the Canadian Triage and Acuity Scale (CTAS) level in 32 patients (33.68%). A logistic regression analysis revealed that pre-testing factors such as age, gender, comorbidities, and chief complaints were not predictors of VBG results, the need for early intervention, or altered CTAS level. Conclusion: Our study concludes that VBG analysis can play an important role in patient triage in the emergency department (ED), allowing for earlier intervention and potentially improving outcomes.","PeriodicalId":498683,"journal":{"name":"The journal of medicine, law and public health","volume":"35 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136312389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
INTRODUCTIONThe aim of this study is to provide a comprehensive review of snake bites in the Arabian Peninsula. METHODS A scoping review was conducted from October to December 2022, and included sources from PubMed, Ovid, the Cochrane Database, reference lists of relevant articles, and grey literature sources such as ClinicalTrials.gov and the World Health Organization’s International Clinical Trials Registry Platform. The keywords used were “Arabian Peninsula”, “Saudi Arabia”, “Qatar”, “Kuwait”, “Oman”, “United Arab Emirates”, “Bahrain”, “Yemen”, “snake venom”, “snake bite”, and “envenomation”. The inclusion criteria for selecting studies were those that explored snake bites in various regions of the Arabian Peninsula. RESULTS 28 studies were included, with a total of 16,602 snake bite cases. In 78.57% of cases, the initial presentation was a local injury. Haematological manifestations were seen in several of the reported cases, while some cases showed neurological symptoms and cardiac manifestation. Leucocytosis, thrombocytopenia/thrombocytosis, and acute kidney injury and proteinuria were also observed. The administered dose of antivenom varied, and post-antivenom complications were seen in less than one third of the reported cases. CONCLUSIONThe current body of literature does not provide a concise management plan for snake bite in the Arabian Peninsula. We provide a proposed plan for treating and monitoring such cases.
{"title":"Snake Bites in The Arabian Peninsula: A Scoping Review","authors":"Ibtihal Alsahabi, Ghadah Alenizi, Rawan Eskandarani","doi":"10.52609/jmlph.v3i3.93","DOIUrl":"https://doi.org/10.52609/jmlph.v3i3.93","url":null,"abstract":"INTRODUCTIONThe aim of this study is to provide a comprehensive review of snake bites in the Arabian Peninsula. METHODS A scoping review was conducted from October to December 2022, and included sources from PubMed, Ovid, the Cochrane Database, reference lists of relevant articles, and grey literature sources such as ClinicalTrials.gov and the World Health Organization’s International Clinical Trials Registry Platform. The keywords used were “Arabian Peninsula”, “Saudi Arabia”, “Qatar”, “Kuwait”, “Oman”, “United Arab Emirates”, “Bahrain”, “Yemen”, “snake venom”, “snake bite”, and “envenomation”. The inclusion criteria for selecting studies were those that explored snake bites in various regions of the Arabian Peninsula. RESULTS 28 studies were included, with a total of 16,602 snake bite cases. In 78.57% of cases, the initial presentation was a local injury. Haematological manifestations were seen in several of the reported cases, while some cases showed neurological symptoms and cardiac manifestation. Leucocytosis, thrombocytopenia/thrombocytosis, and acute kidney injury and proteinuria were also observed. The administered dose of antivenom varied, and post-antivenom complications were seen in less than one third of the reported cases. CONCLUSIONThe current body of literature does not provide a concise management plan for snake bite in the Arabian Peninsula. We provide a proposed plan for treating and monitoring such cases.","PeriodicalId":498683,"journal":{"name":"The journal of medicine, law and public health","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135803768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ghaida Almahawes, Anas AlToijry, Rawan Alboqami, Saud Alnahdi, Bandr Mzahim
INTRODUCTION The safety of patients and property in healthcare settings is directly influenced by security response time, yet this critical aspect is often overlooked. In this article, we aim to address this gap by presenting a proposed key performance indicator (KPI) for security response times. METHODS To develop the proposed KPI, we followed a systematic approach. First, we defined the necessary KPI. We then collected baseline response time data and met with stakeholders to gather their insights. Subsequently, we analysed the response time data from before and after implementation of the proposed KPI, and introduced a levelling method for responses that takes into account the intensity and risk level of each situation. RESULTS The weekly average baseline response time for situations requiring security department intervention was found to be 8 minutes and 1 second. One year after implementing the levelling method, the data comparison revealed a substantial decrease in response times. Specifically, responses to Level 1 incidents averaged 3 minutes and 57 seconds; Level 2 incidents averaged 5 minutes and 47 seconds; and Level 3 incidents averaged 3 minutes and 59 seconds. CONCLUSION The application and testing of this new KPI over the course of one year demonstrated a remarkable impact on security response time. Given the lack of a published benchmark for such response, we propose a benchmark of 5 minutes.
{"title":"Proposing A Key Performance Indicator For Security Response Time Within A Healthcare Facility","authors":"Ghaida Almahawes, Anas AlToijry, Rawan Alboqami, Saud Alnahdi, Bandr Mzahim","doi":"10.52609/jmlph.v3i3.89","DOIUrl":"https://doi.org/10.52609/jmlph.v3i3.89","url":null,"abstract":"INTRODUCTION The safety of patients and property in healthcare settings is directly influenced by security response time, yet this critical aspect is often overlooked. In this article, we aim to address this gap by presenting a proposed key performance indicator (KPI) for security response times. METHODS To develop the proposed KPI, we followed a systematic approach. First, we defined the necessary KPI. We then collected baseline response time data and met with stakeholders to gather their insights. Subsequently, we analysed the response time data from before and after implementation of the proposed KPI, and introduced a levelling method for responses that takes into account the intensity and risk level of each situation. RESULTS The weekly average baseline response time for situations requiring security department intervention was found to be 8 minutes and 1 second. One year after implementing the levelling method, the data comparison revealed a substantial decrease in response times. Specifically, responses to Level 1 incidents averaged 3 minutes and 57 seconds; Level 2 incidents averaged 5 minutes and 47 seconds; and Level 3 incidents averaged 3 minutes and 59 seconds. CONCLUSION The application and testing of this new KPI over the course of one year demonstrated a remarkable impact on security response time. Given the lack of a published benchmark for such response, we propose a benchmark of 5 minutes.","PeriodicalId":498683,"journal":{"name":"The journal of medicine, law and public health","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136357935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maktoom Almalki, Majed Alwahabi, Salem Alammi, Yousef Alawad, Sharafaldeen Bin Nafisah
Background The current models of disaster response focus on international collaborations and assistance. However, little is known about the Saudi health cluster's disaster preparedness and response model. Aim This study aims to describe disaster response steps and elaborates on the administrative structure, timeframes, challenges, and recent lessons learned. Methods We reviewed the current disaster response model of the Saudi Arabian health clustering system. Pre-planned data was reviewed, and disaster contact personnel were contacted for further details. In addition, we portray a recent actual response scenario of code brown of electricity failure, including early activation and subsequent evacuation. Result Three main criteria for determining the emergency response levels are bed capacity, the number of patients affected, and the event's propensity for escalation. Five activation levels are already in place, ranging from local hospital disaster unit response to the involvement of National response led by the Kingdom’s leader. Hospital readiness to receive evacuated patients was tested in a real scenario, and an uneventful evacuation was carried out to demonstrate the effectiveness of the cluster design. Conclusion Overall, the new disaster response model has overcome some reported challenges. However, several challenges still exist, and system evolution is expected.
{"title":"Disaster Cluster Approach: A Study of A New Model of Disaster Response","authors":"Maktoom Almalki, Majed Alwahabi, Salem Alammi, Yousef Alawad, Sharafaldeen Bin Nafisah","doi":"10.52609/jmlph.v3i3.85","DOIUrl":"https://doi.org/10.52609/jmlph.v3i3.85","url":null,"abstract":"Background The current models of disaster response focus on international collaborations and assistance. However, little is known about the Saudi health cluster's disaster preparedness and response model. Aim This study aims to describe disaster response steps and elaborates on the administrative structure, timeframes, challenges, and recent lessons learned. Methods We reviewed the current disaster response model of the Saudi Arabian health clustering system. Pre-planned data was reviewed, and disaster contact personnel were contacted for further details. In addition, we portray a recent actual response scenario of code brown of electricity failure, including early activation and subsequent evacuation. Result Three main criteria for determining the emergency response levels are bed capacity, the number of patients affected, and the event's propensity for escalation. Five activation levels are already in place, ranging from local hospital disaster unit response to the involvement of National response led by the Kingdom’s leader. Hospital readiness to receive evacuated patients was tested in a real scenario, and an uneventful evacuation was carried out to demonstrate the effectiveness of the cluster design. Conclusion Overall, the new disaster response model has overcome some reported challenges. However, several challenges still exist, and system evolution is expected.","PeriodicalId":498683,"journal":{"name":"The journal of medicine, law and public health","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135899875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Efficient planning is crucial for the safe evacuation of dialysis patients during a disaster. The lack of evidence-based approaches for evacuating these patients highlights the need to explore the associated challenges and develop a comprehensive plan to address the unique vulnerabilities of this cohort. Methods: Information was gathered using three methods: First, a thorough literature search was conducted. Secondly, a focus group was established, comprising experts in nephrology, biomedical engineering and safety engineering, as well as senior dialysis nurses. Finally, the research team visited a dialysis centre to examine the dialysis machines and engage in discussions regarding evacuation plans. Results: Three procedures were identified to promptly release patients from a dialysis machine: the ‘clamp and cut’ method, the ‘clamp and cap’ method, and the hand crank method. Factors such as the size and weight of the dialysis machine, battery life, and potential blood loss resulting from immediate interruption of the dialysis process were noted as important considerations. Conclusion: It is essential that dialysis patients be recognized as a vulnerable group, and that time and effort be invested in the design of an evacuation plan specific to their needs.
{"title":"Evacuating Patients with Ongoing Dialysis","authors":"Sharafaldeen Bin Nafisah, Salem Alammi","doi":"10.52609/jmlph.v3i3.90","DOIUrl":"https://doi.org/10.52609/jmlph.v3i3.90","url":null,"abstract":"Introduction: Efficient planning is crucial for the safe evacuation of dialysis patients during a disaster. The lack of evidence-based approaches for evacuating these patients highlights the need to explore the associated challenges and develop a comprehensive plan to address the unique vulnerabilities of this cohort. Methods: Information was gathered using three methods: First, a thorough literature search was conducted. Secondly, a focus group was established, comprising experts in nephrology, biomedical engineering and safety engineering, as well as senior dialysis nurses. Finally, the research team visited a dialysis centre to examine the dialysis machines and engage in discussions regarding evacuation plans. Results: Three procedures were identified to promptly release patients from a dialysis machine: the ‘clamp and cut’ method, the ‘clamp and cap’ method, and the hand crank method. Factors such as the size and weight of the dialysis machine, battery life, and potential blood loss resulting from immediate interruption of the dialysis process were noted as important considerations. Conclusion: It is essential that dialysis patients be recognized as a vulnerable group, and that time and effort be invested in the design of an evacuation plan specific to their needs.","PeriodicalId":498683,"journal":{"name":"The journal of medicine, law and public health","volume":"99 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135586890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Saleh Alhaidar, Adel Korairi, Abdullah Alshehri, Ali Aldufairi, Maya Othman
Background: Sepsis is a serious medical condition and a major cause of morbidity and mortality, and poses challenges in terms of recognition and management. Although studies have investigated the early identification of sepsis and early use of broad-spectrum antibiotics, no clear criteria exist to identify those patients needing additional coverage for resistant organisms. Aims: This study aims to evaluate the utility of previous positive blood or urine culture results in predicting the presence of resistant organisms in septic patients in the emergency department (ED). Methods: This retrospective observational study was conducted at King Fahad Medical City (KFMC), a tertiary care centre in Riyadh, Saudi Arabia, between March and August 2021. Patients aged 18 years or older, who visited the ED at KFMC during the study period, were included if they had a positive blood or urine culture and met the sepsis definition. Result: A total of 133 patients were enrolled (mean age 61.6 [18.3] years), of whom approximately half were male (67, 50.4%). We found that previous colonisation with resistant organisms was more likely in patients with resistant organisms at the time of the enrolled visit (n = 17, 77.3%) than in patients with non-resistant organisms (n = 22, 19.8%, p < .05). Therefore, one statically significant predictor of a current resistant organism is a prior colonisation with a resistant organism (OR = 13.8; 95% CIs 3.6, 51.9; p < .05). Conclusion: Previous cultures, from within the last 12 months, are useful predictors of current resistant organisms, and are therefore essential in guiding empirical antibiotic treatment in septic patients in the ED. Further more extensive and prospective cohort studies on this subject are now needed to mitigate the burden of sepsis on healthcare systems worldwide.
{"title":"Utility of Previous Culture Results for Guiding Empirical Treatment of Sepsis in The Emergency Department","authors":"Saleh Alhaidar, Adel Korairi, Abdullah Alshehri, Ali Aldufairi, Maya Othman","doi":"10.52609/jmlph.v3i3.82","DOIUrl":"https://doi.org/10.52609/jmlph.v3i3.82","url":null,"abstract":"Background: Sepsis is a serious medical condition and a major cause of morbidity and mortality, and poses challenges in terms of recognition and management. Although studies have investigated the early identification of sepsis and early use of broad-spectrum antibiotics, no clear criteria exist to identify those patients needing additional coverage for resistant organisms. Aims: This study aims to evaluate the utility of previous positive blood or urine culture results in predicting the presence of resistant organisms in septic patients in the emergency department (ED). Methods: This retrospective observational study was conducted at King Fahad Medical City (KFMC), a tertiary care centre in Riyadh, Saudi Arabia, between March and August 2021. Patients aged 18 years or older, who visited the ED at KFMC during the study period, were included if they had a positive blood or urine culture and met the sepsis definition. Result: A total of 133 patients were enrolled (mean age 61.6 [18.3] years), of whom approximately half were male (67, 50.4%). We found that previous colonisation with resistant organisms was more likely in patients with resistant organisms at the time of the enrolled visit (n = 17, 77.3%) than in patients with non-resistant organisms (n = 22, 19.8%, p < .05). Therefore, one statically significant predictor of a current resistant organism is a prior colonisation with a resistant organism (OR = 13.8; 95% CIs 3.6, 51.9; p < .05). Conclusion: Previous cultures, from within the last 12 months, are useful predictors of current resistant organisms, and are therefore essential in guiding empirical antibiotic treatment in septic patients in the ED. Further more extensive and prospective cohort studies on this subject are now needed to mitigate the burden of sepsis on healthcare systems worldwide.","PeriodicalId":498683,"journal":{"name":"The journal of medicine, law and public health","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134914753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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