Medicina Katastrof
type: channel
description: The journal welcomes all kind of research/review/abstract papers regarding Health Professions (miscellaneous), Emergency Medical Services, Emergency Medicine, Public Health, Environmental and Occupational Health and so on. Medicina Katastrof (ISSN:2070-1004) (E-ISSN:2686-7966) Latest Journal Published Here MK-20-04-2025-2112 / Medicina Katastrof (ISSN:2070-1004) (E-ISSN:2686-7966) Tele-Medical Technologies Usage In Medical Treatment Organizations Of Federal Medical And Biological Agency The main issues of provision of medical help and treatment with usage of tele-medical technologies (TMT) were considered, including victims in emergency situations (ES), in medical treatment organizations (MTO) of Federal Medical and Biological Agency (FMBA of Russia). Noticed that an experience of conducting of tele-medical consultations (TMC) which was made in All-Russian Center of Disaster Medicine “Zashchita” (was handed over to FMBA of Russia in 2020) allowed to increase number of MTO of FMBA of Russia which are participated in conducting of medical consultation by the sche Learn More MK-08-01-2025-2112 / Medicina Katastrof (ISSN:2070-1004) (E-ISSN:2686-7966) Integrating Virtual Reality and Artificial intelligence Tools to Optimize Interprofessional Coordination in Clinical Care Interprofessional coordination breakdowns contribute substantially to adverse events in clinical care, with up to 10% of hospital patients affected and millions of associated deaths worldwide. Emerging technologies—artificial intelligence (AI) and virtual reality (VR)—offer synergistic opportunities to enhance team communication, decision making, and workflow efficiency, yet their combined impact on multidisciplinary coordination has not been systematically evaluated... Learn More MK-07-01-2025-2112 / Medicina Katastrof (ISSN:2070-1004) (E-ISSN:2686-7966) Evaluating Infection‐Control Practice Among Surgical, Anesthesia, and Radiology Teams Healthcare‐associated infections (HAIs) in perioperative and imag…
language: en
publication name: Medicina Katastrof
items: SGLT2 Inhibitors Versus Intensive Low-Carbohydrate Dietary Programs for Glycemic Control and Early Detection of Renal Outcomes in Type 2 Diabetes
items: Integrated Sepsis Detection Protocols Using Clinical Scores and Laboratory Triggers Versus Routine Assessment in Adult Emergency Patients
items: De-escalation Training to Reduce Workplace Violence in Emergency Nurses:A Systematic Review
items: Artificial Intelligence Support For Digital Breast Tomosynthesis And 2DMammography: A Systematic Review Of Diagnostic Accuracy
items: Comparative Effectiveness of Video and Direct Laryngoscopy on First-Pass Success andPeri-intubation Events
items: Comparing Devices and Training for Needlestick-Injury Prevention: A SystematicReview
items: Care Pathways Combining Anesthesia Practices and Nursing Interventions forPostoperative Delirium Prevention
items: Digital Morphology for Peripheral Blood Smears in Leukemia Detection:A Systematic Review
items: Acquired Methemoglobinemia from Local Anesthetics Used for Airways:Incidence, Risk Factors, and Management
items: Digital-Era Nurse Leadership and Psychological Empowerment DuringeHealth Implementation: A Systematic Review
items: Impact of Patient-Assisted Compression and Pressure-Guided Paddles onMammography/DBT Performance
items: Emergency Medical Services Use of Capillary Ketone Meters for SuspectedDiabetic Ketoacidosis: A Systematic Review
items: Same-Day Screening of Diabetic Complications in Outpatient Clinics: ASystematic Review
items: Skin and Allergic Conditions Linked to Personal Protective Equipment inHealthcare Workers: Burden, Prevention, and Care
items: Vasopressor Strategy for Neuraxial Related Hypotension During CrashCesarean
items: Pharmacogenomic Guided Pain Management in Surgery: Patient PainOutcomes
items: Influence of Abutment Retention Method on Dental Implant Prosthesis: Implant Stability and Screw Loosening
items: Nurse-Led Ultrasound at Point of Care (POCUS) in Emergency and Critical Care: Accuracy and Outcomes
items: Preventing Perioperative Hypothermia in Obstetric Surgery: A Systematic Review of Warming Methods During Cesarean Birth
items: Radiation Exposure to Anesthetists During Interventional Radiology Procedures: A Systematic Review of Occupational Safety
items: Efficacy of dexmedetomidine sedation by anesthesia technicians for pediatric MRI/CT procedures
items: Liver Determination of Length using Sonography: A Cross-sectional Study
items: Diagnostic performance and patient outcomes of ultrasound use in trauma triage by Emergency Medical Services teams
items: Impact of Shift Work and Long Working Hours on Sleep Quality and Clinical Performance Among Health Professionals
items: Early-Warning Score Systems Supervised by Nurses and Their Impact on Quality of Healthcare
items: Continuous Versus Intermittent Fetal Oxygen Saturation Monitoring Under Regional Anesthesia
items: Enhanced Recovery After Surgery (ERAS) Pathways in Tertiary Hospitals: Effects on Post-operative Opioid Use and Length of Stay
items: Integrating Virtual Reality and Artificial intelligence Tools to Optimize Interprofessional Coordination in Clinical Care
items: Evaluating Infection‐Control Practice Among Surgical, Anesthesia, and Radiology Teams
items: Effectiveness of National Reporting Systems in Capturing Adverse Drug Events Across Healthcare Cadres

SGLT2 Inhibitors Versus Intensive Low-Carbohydrate Dietary Programs for Glycemic Control and Early Detection of Renal Outcomes in Type 2 Diabetes
type: item
description: Background: Type 2 diabetes is highly prevalent and frequently complicated by chronic kidney disease. Sodium–glucose cotransporter-2 inhibitors (SGLT2i) and intensive low-carbohydrate dietary programs both improve glycaemia, but their comparative effects on early renal outcomes remain uncertain. Methods: A systematic search of PubMed and trial registries identified randomized and cohort studies in adults with type 2 diabetes evaluating SGLT2i or intensive low-carbohydrate programs versus usual care or higher-carbohydrate diets. Two reviewers independently screened records, extracted data, assessed risk of bias, and performed narrative synthesis. Results: Of 1,462 records, 9 studies (6 trials, 3 cohort/real-world; >19,000 participants) met inclusion criteria. Intensive low-carbohydrate programs produced larger short-term HbA1c reductions (−0.6 to −1.3 percentage points at 3–12 months) and 7–12 % weight loss, often allowing major de-intensification or discontinuation of insulin. SGLT2i yielded more modest but durable HbA1c reductions (−0.3 to −0.6 percentage points) and 2–4 kg weight loss with blood-pressure lowering. Across outcome trials and cohorts, SGLT2i reduced composite renal endpoints by about 30–40 % (hazard ratios =0.60–0.70; 95 % confidence intervals excluding 1.00), whereas low-carbohydrate interventions appeared renally neutral over 1–2 years. Conclusions: Both SGLT2i and intensive low-carbohydrate programs improved glycaemic control and cardiometabolic risk in adults with type 2 diabetes, but only SGLT2i showed robust renoprotective effects. These strategies may be complementary, and choice should consider renal risk, obesity, treatment goals, and capacity for sustained dietary change.
subject: Articles
  topic: section
subject: Type 2 diabetes mellitus
  topic: keywords
subject: Sodium-glucose cotransporter 2 inhibitors,
  topic: keywords
subject: Low-carbohydrate die
  topic: keywords
subject: Glycemic control
  topic: keywords
creator: Qassim Abdulatif Ahmad Algurairy¹, Hamad Mohammed Hamad Alhamad², Wasel Hassan Taher Alhashem³, Hussain Salman Alhassan⁴, Dalia Hassan Ibrahim Aljabr⁵, Ali Hussain Almeshqab⁶
rights: Copyright (c) 2025 Medicina Katastrof
date: 2025-11-25
publication date: 2025-11-25

Integrated Sepsis Detection Protocols Using Clinical Scores and Laboratory Triggers Versus Routine Assessment in Adult Emergency Patients
type: item
description: Background: Integrated sepsis detection protocols combining clinical scores with laboratory triggers are increasingly used in emergency departments, but their added value over routine assessment remains uncertain. Methods: A PubMed search identified studies comparing integrated sepsis detection protocols (clinical score plus laboratory trigger) with routine clinician assessment in adult emergency settings. Two reviewers selected studies, extracted data, and assessed risk of bias. Primary outcomes were time to antibiotics, intensive care unit (ICU) admission, and mortality; secondary outcomes were process measures and length of stay. Results: Fourteen studies (2 randomised or pragmatic trials, 12 cohort or beforeafter; >20,000 patients) were included. Integrated protocols consistently shortened time to first intravenous antibiotics, with median reductions of 2077 minutes versus usual care and 1-hour antibiotic compliance increase. Completion of bundle elements such as lactate measurement and initial fluid bolus improved, with gains of 2030 percentage points. Overall ICU admission rates were largely unchanged, although some studies reported more timely direct ICU transfer. Mortality effects were heterogeneous; several studies showed in-hospital mortality reductions of 411 percentage points, whereas others reported no significant difference. Conclusions: Across emergency care settings, integrated sepsis detection protocols improved timeliness and completeness of early sepsis management and may reduce mortality when linked to effective response pathways. These findings support local adaptation and implementation of integrated protocols as a component of sepsis quality-improvement initiatives in emergency departments.
subject: Articles
  topic: section
subject: Sepsis
  topic: keywords
subject: Emergency Service,
  topic: keywords
subject: Early Diagnosis
  topic: keywords
subject: Quality Improvement
  topic: keywords
creator: Yousef Ali Fahed Alsalem¹, Yousef Hasan Taher Alhashem², Yousef Mohammad Al-Mohammad saleh³, Bader Ahmed Abdulmohsen Alshagageeg⁴, Ahmad Ali Mohammad Alalaiwi⁵, Abdullah Fahed Ahmed Alsalem⁶, Ali Abdullah Alshakhas⁷, Abdullah Saad Alqarni⁸
rights: Copyright (c) 2025 Medicina Katastrof
date: 2025-11-25
publication date: 2025-11-25

De-escalation Training to Reduce Workplace Violence in Emergency Nurses:A Systematic Review
type: item
description: Background: Workplace violence against emergency nurses is highly prevalent and threatens staff safety, morale, and retention. De De-escalation training is widely promoted as a core strategy to manage aggression, but its effectiveness in reducing violence and related harms in emergency departments remains uncertain. Methods: A systematic search of databases identified clinical trials and cohort studies evaluating de de-escalation or violenceviolence-prevention training for emergency nurses. Ten studies (randomised cluster trials, controlled cohorts, and pre pre-post designs) were included. Primary outcomes were workplace violence incidence and staff injuries; secondary outcomes were de de-escalation knowledge, confidence, attitudes, reporti ng behaviours, and psychological impacts. Risk of bias was assessed with design design-appropriate tools, and findings were synthesised narratively. Results: The 9 studies enrolled approximately 800 800-1,000 emergency nurses, with follow follow-up ranging from immediately postpost-training to 24 months. A large cluster trial reported a 52 % reduction in physical violence at 6 months (incident rate ratio 0.48; 95 % CI 0.29 0.29-0.80) and 63 % lower injury risk at 24 months (incident rate ratio 0.37; 95 % CI 0.17 0.17-0.83). A quasi quasi-exper imental study found workplace violence prevalence declined from 63.9 % to 46.2 % (18 % absolute risk reduction). Across studies, de de-escalation training consistently improved knowledge, confidence, and attitudes, but effects on incident rates were modest, h eterogeneous, and sometimes short short-lived. Conclusions: De -escalation training substantially enhanced emergency nurses’ competencies and perceived preparedness but only variably reduced workplace violence and injuries, with the most robust benefits observed when training was embedded in multifaceted organisational prevention programmes.
subject: Articles
  topic: section
subject: Workplace Violence
  topic: keywords
subject: Emergency Nursing
  topic: keywords
subject: De escalation
  topic: keywords
subject: Agression
  topic: keywords
creator: Dawood Salman Mohammed Aluthman, Fatima AbdMalik Mohd Aljuraidan, Zahrah Ahmed Hussin Alahmed, Hani Ali Abdullah Al-Hasan, Mariam Ali Mohammed Al-Fajri, Majid Abdullah Alwosaibai, Adraa Ibrahim Alshoreet, Nawal Abdul-Wahab Alibrahim
rights: Copyright (c) 2025 Medicina Katastrof
date: 2025-11-26
publication date: 2025-11-26

Artificial Intelligence Support For Digital Breast Tomosynthesis And 2DMammography: A Systematic Review Of Diagnostic Accuracy
type: item
description: Background: Artificial intelligence support for digital breast tomosynthesis and two dimensional mammography is increasingly integrated into breast cancer screening, yet the overall diagnostic accuracy and impact on workflow across clinical settings remain uncertain. Methods: A systematic search of PubMed from inception to May 2024 identified clinical trials and cohort studies evaluating artificial intelligence systems used as standalone readers or as decision support for radiologists in digital mammography or digital breast tomosynthesis. Studies were eligible if they reported diagnostic accuracy outcomes such as sensitivity, specificity, area under the receiver operating characteristic curve, cancer detection rate, or recall rate. Two reviewers performed screening, data extraction, and risk of bias assessment using a standardised tool, with narrative synthesis only. Results: Nine studies, including more than 560,000 mammographic examinations, met the inclusion criteria. Standalone artificial intelligence achieved area under the curve values around 0.84 to 0.94 and was non inferior to average radiologists in several datasets. Concurrent artificial intelligence support increased reader area under the curve by about 0.02 to 0.06, raised sensitivity by approximately 3 to 10 percentage points, and reduced reading time by 20 to 50 percent. In large screening cohorts, cancer detection rates increased by about 14 to 18 percent, while recall rates were either stable or modestly reduced and positive predictive value improved by roughly 3 to 5 percent. Conclusions: Artificial intelligence support for digital mammography and digital breast tomosynthesis shows consistent gains in diagnostic accuracy and efficiency, although effect sizes vary by modality, integration strategy, and case mix, and long term clinical outcomes still require confirmation.
subject: Articles
  topic: section
subject: Breast Neoplasms, Mammography, Tomography X-Ray Computed, Artificial Intelligence, Mass Screening, Computer-Assisted Diagnosis.
  topic: keywords
creator: Hamad Salem Al Yami ¹, Hawraa Hejji Saleh Aljumaiah ², Huda Ridha Alessa ³, Maryem Abdullah Al Alosayif ⁴, Rabab Mansour Al Hashem ⁵, Bashayr Mohammed Musawwid Asiri ⁶
rights: Copyright (c) 2025 Medicina Katastrof
date: 2024-11-28
publication date: 2024-11-28

Comparative Effectiveness of Video and Direct Laryngoscopy on First-Pass Success andPeri-intubation Events
type: item
description: Background: First-pass success during tracheal intubation is critical for reducing peri-intubation complications, especially in emergency and critical care settings. Video laryngoscopy may offer advantages over direct laryngoscopy in improving glottic visualization and intubation outcomes. Methods This systematic review included studies comparing video and direct laryngoscopy in adult patients undergoing tracheal intubation in operating rooms, emergency departments, or intensive care units. A comprehensive PubMed search (inception-July 2025) identified randomized clinical trials and cohort studies reporting first-pass success and related outcomes. Results Eight studies (five randomized trials, three cohorts; n = 8,700) met inclusion criteria. First-pass success rates ranged from 61.9% to 98.3% for video laryngoscopy and 59% to 96.2% for direct laryngoscopy. Four studies reported significantly higher success with video (e.g., 85.1% vs 70.8%; risk difference 14.3%, 95% CI 9.9-18.7). Two studies showed no difference, and one favored direct laryngoscopy in a prehospital setting. Video laryngoscopy reduced esophageal intubation (RR 0.44, 95% CI 0.24-0.80) and aspiration risk (RR 0.63, 95% CI 0.41-0.96), with similar rates of hypoxemia and hypotension. Time to intubation was marginally longer with video but not clinically significant. Conclusions Video laryngoscopy improves first-pass success and reduces airway-related complications compared to direct laryngoscopy in most adult emergency and perioperative intubations. Operator training and setting influence effectiveness.
subject: Articles
  topic: section
subject: Video laryngoscopy, direct laryngoscopy, airway management, tracheal intubation, first-pass success, critical care.
  topic: keywords
creator: Anas Ismail Alkhdour¹, Anas Yahia Abdo Alasmari², Abdullah Saad Alshahrani³, Walled Abdullah AlSufyani⁴, Saleh Ghazia Falah Alharbi⁵, Abdulrahman Mohammed Alasmari⁶, Ahmed Mohammed Hadadi⁷, Sultan Khaled Alhussaini⁸
rights: Copyright (c) 2025 Medicina Katastrof
date: 2025-11-14
publication date: 2025-11-14

Comparing Devices and Training for Needlestick-Injury Prevention: A SystematicReview
type: item
description: Background: Needlestick injuries are frequent among nurses and dental assistants and carry substantial risk of blood borne infection. Safety engineered devices and education programmes are both promoted for prevention, yet their comparative effectiveness and feasibility for these staff groups remain uncertain. Methods: Studies that evaluated safety engineered needle devices, education or combined interventions to reduce needle related injuries in nurses or dental assistants were identified through PubMed and supplementary databases from inception to August 2025. Clinical trials, quasi experimental studies and cohort designs reporting injury incidence or rates were eligible. Thirteen studies met inclusion criteria, of which ten were clinical trials or cohort studies. Risk of bias was appraised with design appropriate tools, and findings were synthesised narratively. Results: Safety engineered devices consistently reduced injury rates, typically by 40-60 percent relative to conventional needles, for example from 3.39 to 1.50 injuries per 100 full time equivalent staff, or with relative risks around 0.3-0.6. Education alone improved knowledge and reported safe practices but produced smaller and sometimes transient reductions, for example self-reported injury prevalence falling from 40 percent to 15 percent over 3-6 months. Interventions that combined devices and training achieved the largest effects, with odds ratios around 0.3 compared with usual practice. Heterogeneity in design, outcome definition and follow up limited formal pooling. Conclusions: Evidence indicated that passive safety engineered devices substantially reduced needle related injuries, and that combining such devices with structured training offered the greatest protection for nurses and dental assistants. Education alone was beneficial but less effective and required repetition to sustain impact.
subject: Articles
  topic: section
subject: Needlestick Injuries, Safety Devices, Education, Nursing, Dental Assistants, Occupational Exposure.
  topic: keywords
creator: Halima Salman A. Karim Alenaki¹, Safa Habib Alhubail², Azhar Ali Al Omani³, Wejdan Mohammed Al Barrak⁴, Eman Abdullah Yusef Al Abbas⁵, Sakina Yagoub Yousef Al Sulais⁶
rights: Copyright (c) 2025 Medicina Katastrof
date: 2025-11-14
publication date: 2025-11-14

Care Pathways Combining Anesthesia Practices and Nursing Interventions forPostoperative Delirium Prevention
type: item
description: Background: Postoperative delirium (POD) is a frequent, harmful complication after surgery. Multicomponent pathways that coordinate anesthesia practices with nurse-led prevention strategies are increasingly adopted, yet their effectiveness across surgical settings remains variably reported. Methods: A systematic search of PubMed (to July 2025) identified studies evaluating integrated anesthesia-nursing pathways for POD prevention in adult inpatients. Randomized and observational designs were eligible. Primary outcome was POD incidence (validated tools); secondary outcomes included delirium duration, length of stay, pain, sleep quality, and early recovery. Results: Thirteen studies met criteria (9 randomized trials and 4 cohorts). Multicomponent pathways frequently reduced POD versus usual care, especially in higher-risk populations. Examples included an antiinflammatory drug bundle in hip-fracture surgery (15% vs 44%; RR =0.33) and esketamine plus dexmedetomidine in thoracic surgery (14.6% vs 30.9%; RR=0.47). A large implementation cohort reported a month-over-month decline in delirium after bundle rollout (adjusted odds ratio 0.96; 95% confidence interval 0.94-0.97). Secondary outcomes generally favored intervention groups, including shorter hospitalization, improved sleep, lower pain, and higher early recovery scores. Conclusions: Integrated perioperative pathways that combine anesthesia optimization with nurse-led nonpharmacologic measures were associated with lower delirium and better recovery metrics, whereas single-component changes often showed limited effect. Adoption should emphasize multicomponent design, staff training, and implementation fidelity, with pragmatic trials to standardize effective elements across surgical contexts.
subject: Articles
  topic: section
subject: Postoperative delirium, perioperative care, anesthesiology, nursing, care bundles, enhanced recovery, outcomes
  topic: keywords
creator: Wasayf Salah Al Muraysel ¹, Mohammed Abdullah Al Khalifah 2, Latifa Mohammed Bubshait 3, Meshari Mohammed Algarzai 4, Turki Abdullah Alzahrani 5, Naifah Abdullah Al Amiri 6, Nabiha Yousf Almudhwi 7, Laila Ibrahim Alsaihati 8
rights: Copyright (c) 2025 Medicina Katastrof
date: 2025-10-28
publication date: 2025-10-28

Digital Morphology for Peripheral Blood Smears in Leukemia Detection:A Systematic Review
type: item
description: Background: Peripheral blood smear examination is foundational for leukemia detection, yet manual review is laborintensive and variable. Digital morphology and artificial intelligence (AI) systems promise faster triage and standardized classification. This review synthesized diagnostic accuracy for detecting leukemia on peripheral smears. Methods: PubMed was searched from inception to April 2025. Eligible studies were observational diagnosticaccuracy cohorts evaluating digital morphology or AI on peripheral blood smear images against manual microscopy or integrated clinical diagnosis. The primary outcome was sensitivity/specificity; secondary outcomes included predictive values, agreement, and time to result. Results: Of 1,245 records, 245 duplicates were removed and 1,000 titles/abstracts were screened; 80 full texts were reviewed and 10 cohorts were included. Digital analyzers showed high specificity for common leukocytes (often >90-95%); blast sensitivity varied by platform and case-mix. A compact analyzer reported specificity >94% with blast sensitivity 21-86%. Another platform achieved blast sensitivity 98.4% and specificity 64.0%. AI-assisted APL screening yielded sensitivity 95.8% and specificity 100.0%. Image-classification studies reported sensitivity 97.86% and specificity 100.0% on held-out tests, with APL recall 97.4%. Post-verification correlations for abnormal differentials exceeded 0.93, and PPV/NPV were frequently ≥95%. Conclusions: Digital morphology and AI reliably triaged peripheral smears with high specificity and context-dependent blast sensitivity. They are best deployed as screening tools with mandatory expert confirmation, supported by local validation and external prospective AI verification.
subject: Articles
  topic: section
creator: Shafi Fiyadh Kasb Alshammari¹, Salem Mousa Ahmed Alzahrani², Afnan Abdullah Dhafer Alshehri³, Ramadan Juma’an Ramadan Alzahrani⁴, Abdullah Ahmed Abdullah Alzahrani⁵
rights: Copyright (c) 2025 Medicina Katastrof
date: 2025-10-27
publication date: 2025-10-27

Acquired Methemoglobinemia from Local Anesthetics Used for Airways:Incidence, Risk Factors, and Management
type: item
description: Background: Acquired methemoglobinemia from topical/local anesthetics used for airway procedures is uncommon but clinically important. Risk appears highest with benzocaine sprays during transesophageal echocardiography (TEE) or bronchoscopy, whereas standard-dose lidocaine typically yields only minor, asymptomatic methemoglobin (MetHb) changes. Methods: We systematically searched PubMed (to June 2025), screened records in duplicate, and included observational clinical trials or cohort/case-control studies evaluating airway topical/local anesthetics and methemoglobinemia. Data were extracted in duplicate and synthesized narratively without meta-analysis due to heterogeneity in designs, exposures, and outcome definitions. Results: Nine observational studies met eligibility (0 randomized trials). Across mixed procedure cohorts, incidence was low (0.035% overall; 33/94,694 procedures), with higher procedure-specific rates for TEE (0.250%) and bronchoscopy (0.160). A large TEE program reported benzocaine-associated incidence 0.067% (95% CI 0.040-0.100). Inpatient status markedly increased risk (13.7 vs 0.14 per 10,000 for inpatients vs outpatients). Prospective studies of lidocaine topicalization/infiltration showed trivial mean MetHb shifts (e.g., =0.5% to 0.6%) without clinical toxicity. Conclusions: Airway topical/local anesthetic-associated methemoglobinemia is rare and concentrated around benzocaine spray in medically complex inpatients. Routine lidocaine use at standard doses demonstrated minimal clinical risk. Early recognition with co-oximetry and timely methylene blue remain central to excellent outcomes, and risk can be minimized through agent selection and dosing discipline.
subject: Articles
  topic: section
subject: Methemoglobinemia, Airway management, Anesthetics local, Benzocaine, Lidocaine, Transesophageal echocardiography
  topic: keywords
creator: Maher Ahmed Hamad Al Sultan¹, Shaker Ahmed Abdullah Al Faraj², Omar Adel Omar Alsubaie³, Abdullah Shafi Rajeh Alshehri⁴, Bayan Mansour Hamad Almansour⁵ Bashayer Sulaiman Rubayyi Alshammari⁶, Norah Adel Abdulaziz Al Jaber⁷, Zahra Ali Alhazza⁸
rights: Copyright (c) 2025 Medicina Katastrof
date: 2025-08-05
publication date: 2025-08-05

Digital-Era Nurse Leadership and Psychological Empowerment DuringeHealth Implementation: A Systematic Review
type: item
description: Background: Hospitals continue to scale telehealth and electronic health records (EHRs), placing nurse leadership and psychological empowerment at the center of successful implementation. Leadership that protects learning time, ensures responsive support, and involves nurses in redesign is theorized to improve adoption and retention. Methods: A systematic search (PubMed) from inception to May 2025 identified studies of hospital-based nurses examining leadership constructs and psychological empowerment during telehealth/EHR implementation. Eligibility required quantitative or mixed-methods designs reporting adoption or retention (intent-to-stay/leave) and empowerment measures. Two reviewers screened, extracted, and synthesized data narratively in line with PRISMA. Results: Nine observational studies (cross-sectional or cohort) were included. Adoption-related findings showed that leadership and empowerment-adjacent factors (competence, autonomy, self-efficacy) were associated with higher readiness and use. Examples included EHR readiness 52.8% (95% CI 47.9-56.6) with higher odds among staff with positive attitudes and technology self-efficacy; comprehensive EHRs were associated with fewer fair/poor quality ratings (OR 0.83; 95% CI 0.71-0.96). Implementation leadership independently predicted nurses’ actual use of mobile health at the point of care (β 0.22; p=0.001). Conclusions: Across diverse hospital settings, digitally competent, supportive leadership that fosters psychological empowerment aligned with higher eHealth adoption and more favorable retention signals. Implementation programs should integrate leadership development, co-design, usability remediation, and protected learning time.
subject: Articles
  topic: section
creator: Farah Abdulaziz Al-Abdrabalnabi¹, Abrar Hassan Al-Abdulaal², Asadiah Hassan Al-Ghazwi ³, Rabab Jaber Al- Hammad⁴, Fatimah Jaber Al-Hammad⁵, Zainab Ali Alrubeh⁶, Noor Jamal Alzayer⁷, Mortadh Jaffar Ali Al-Salem⁸, Sawsan Shareedah Al-Turaiky⁹
rights: Copyright (c) 2025 Medicina Katastrof
date: 2025-07-27
publication date: 2025-07-27

Impact of Patient-Assisted Compression and Pressure-Guided Paddles onMammography/DBT Performance
type: item
description: Background: Breast compression optimizes image quality and dose in mammography and digital breast tomosynthesis (DBT), yet pain can deter re-attendance. Patient-assisted compression (PAC) and pressureguided paddles aim to improve tolerability while preserving technical performance. Methods: A PRISMA-conformant PubMed search (inception-31 March 2025) identified English-language human studies comparing PAC or pressure-/shape-guided paddles with technologist-controlled compression. Two reviewers screened/extracted data with calibration (κ=0.84) and used Joanna Briggs Institute tools for risk of bias. No meta-analysis was undertaken. Results: Of 1,063 records (92 duplicates removed), 971 titles/abstracts were screened and 102 full texts assessed; 12 studies were included (3 randomized trials, 9 cohorts; sample sizes 39-25,286). The primary outcome, pain (0-10 scale), was modestly reduced: a multicentre trial of curved paddles showed a mean difference -0.19 (95% CI -0.28 to -0.09); a PAC randomized study reported lower discomfort (P=0.014). A DBT cohort reported mean pain 1.9/10 with 19.3% moderate/severe. Pressure-guided flexible paddles standardized compression, lowering thickness (-3.74 mm craniocaudal; -6.70 mm mediolateral oblique), reducing pressure variability (-55% and -34%), and decreasing average glandular dose (AGD) (-0.13 mGy MLO); 87% would recommend. Implementation studies reduced mean pressure (17.1to12.8 kPa) and “over-compressed” views (26% to 2%). Conclusions: PAC and pressure-guided paddles provided small but consistent gains in patient experience and compression standardization without systematic loss of image quality or dose performance. Implementation should prioritize pressure targets (8-14 kPa), structured PAC coaching, and monitoring of positioning, recalls, dose, and re-attendance.
subject: Articles
  topic: section
subject: mammography, digital breast tomosynthesis, breast compression, patient-assisted compression, pressure-guided paddles, average glandular dose
  topic: keywords
creator: Samar Abdulhameid Alfraij¹, Mazen Alghamdi², Sahar Nasser Albishi³, Ashwag Nasser Othman Albishi⁴ Fatima Obaid Jaber Albishi⁵, Abdulaziz Sulaiman Abdulaziz Al Oraini⁶, Aishah Nasser Almubayyedh⁷
rights: Copyright (c) 2025 Medicina Katastrof
date: 2025-07-20
publication date: 2025-07-20

Emergency Medical Services Use of Capillary Ketone Meters for SuspectedDiabetic Ketoacidosis: A Systematic Review
type: item
description: Background: Diabetic ketoacidosis is a time-critical emergency; emergency medical services (EMS) may benefit from capillary β-hydroxybutyrate testing to improve recognition and trigger early care pathways. Methods: PubMed, Scopus, citation lists, and trial registries were searched from inception to 30 September 2024 for clinical trials and cohort studies evaluating EMS-performed capillary ketone measurement in suspected diabetic ketoacidosis. Dual screening, duplicate data extraction, and designappropriate risk-of-bias tools (QUADAS-2/JBI) were used. A narrative synthesis was conducted without meta-analysis. Results: Of 263 records identified, 71 duplicates were removed; 192 titles/abstracts were screened, 29 full texts were assessed, and 1 stepped-wedge feasibility cohort was included. The multicentre United Kingdom study enrolled 388 EMS encounters (control 203; intervention 185) and implemented a “highrisk DKA” bundle triggered by capillary β-hydroxybutyrate ≥3.0 mmol/L. Recognition of suspected highrisk diabetic ketoacidosis increased from 2.5% (5/203) to 6.5% (12/185), a +4.0 percentage-point difference. Among hospital-diagnosed cases, prehospital crystalloid initiation rose from 33.3% (3/9) to 45.5% (5/11). Hospital pre-alerting increased qualitatively, while scene-time effects were not reported. No device-related serious adverse events were described; paramedic and emergency-department staff reported the approach as feasible and acceptable. Large contextual cohorts without prehospital ketone testing were excluded but highlighted the implementation gap. Conclusions: EMS capillary ketone testing appeared feasible and was associated with improved early recognition and pre-arrival actions, though evidence was limited to a single underpowered feasibility cohort. Protocolized implementation with audit is reasonable, and multicentre effectiveness studies reporting patient-centred outcomes are needed.
subject: Articles
  topic: section
subject: Emergency Medical Services, Diabetic Ketoacidosis, β-Hydroxybutyrate, Point-of-Care Testing, Prehospital Care, Diagnostic Pathways
  topic: keywords
creator: Saleh Abdullah Ali Al Dighrir¹, Mujahid Dhafir Saleh Alyami², Amer Saleh Ali Almahri Alyami³, Abdulaziz Ahmed Bin Marshad Alyami⁴, Faris Mahdi Salem Aldighrir⁵, Mansour Saleh Hussein Almahri⁶, Amer Mohammed Alkhurim⁷
rights: Copyright (c) 2025 Medicina Katastrof
date: 2024-11-18
publication date: 2024-11-18

Same-Day Screening of Diabetic Complications in Outpatient Clinics: ASystematic Review
type: item
description: Background: Fragmented, multi-visit screening for diabetic retinopathy, kidney disease, and neuropathy in routine care leads to missed tests and delayed referral. Same-day, multi-component screening in outpatient clinics is proposed to improve completion and diagnostic yield. Methods: A PRISMA-guided review searched PubMed from inception to September 2024 (Humans, English). Eligible designs were clinical trials or cohorts evaluating same-day screening bundles assessing ≥2 complication domains (retina, kidney, foot/neuropathy) within one outpatient encounter, versus usual care or pre-implementation periods. Primary outcome was completion of all eligible screens during the visit; secondary outcomes included detection yield, referral/process measures, patient experience, and safety. Results: Ten studies (all observational cohorts; 5 before-after, 3 prospective, 2 quasi-experimental) met criteria, from the UK, Europe, North America, and the Middle East. Sample sizes ranged 236-4,022. Integration models most commonly combined non-mydriatic retinal imaging with foot/neuropathy testing and urine albumin-to-creatinine ratio. Across studies, same-day programs increased multi-domain completion versus prior workflows (reported directionally in 6/10). Detection yields at the index visit were substantial: moderate/high-risk foot 56.6%, new painful neuropathy 25%, peripheral artery disease 19-26%, and sensory neuropathy 3-31%, while retinal imaging identified previously unrecognized diabetic retinopathy in routine primary-care pathways. Conclusions: Same-day, bundled screening in outpatient clinics was feasible and acceptable, with consistent gains in completion and meaningful same-visit detection of microvascular complications. Health systems should pilot co-located models with standardized referral protocols and measure completion, yield per 100 screened, time-to-referral, and costs.
subject: Articles
  topic: section
subject: Diabetes mellitus, Diabetic retinopathy, Diabetic neuropathies, Albuminuria, Point -of-care systems, Primary health care
  topic: keywords
creator: Mohsen Hassan Alwalan¹, Hamad Masoud Alyami², Mansour Saeed Althaibah³, Hadi Ali Mana⁴, Mohamed Hadi Almunyif⁵, Rashed Saleh Saud Almurdif⁶, Rawan Ezzi Abufaia⁷
rights: Copyright (c) 2025 Medicina Katastrof
date: 2024-11-17
publication date: 2024-11-17

Skin and Allergic Conditions Linked to Personal Protective Equipment inHealthcare Workers: Burden, Prevention, and Care
type: item
description: Background: Personal protective equipment is essential in healthcare, yet sustained use can provoke irritant and allergic skin conditions that impair comfort, adherence, and work ability. A synthesis focused on burden, prevention, and care is needed to guide procurement and practice. Methods: A protocol driven search of PubMed identified studies from inception to March 2025. Eligible designs were clinical trials and cohort studies that evaluated healthcare workers using gloves, masks, respirators, goggles, or face shields, and reported dermatologic outcomes with explicit definitions. Screening and extraction were performed in duplicate, risk of bias was appraised by design specific tools. No metaanalysis was performed. Results: Fourteen studies met criteria, seven cohorts and three trials, sample sizes ranged from 17 to 2,053, follow up ranged from 3 days to 10 years. In a hospital cohort, hand rub applied on wet skin increased hand eczema risk, odds ratio 1.78, 95 percent confidence interval 1.11 to 2.87. Apprentice cohorts reported new onset eczema with frequent washing, odds ratio 1.5, 90 percent confidence interval 1.0 to 2.3. Longitudinal glove programs still detected latex sensitization at 1.0 per 1,000 person years and allergic contact dermatitis at 2.50 per 1,000 person years. Consecutive respirator wear increased facial transepidermal water loss and corneocyte fragility over three shifts, consistent with early barrier injury. A cluster trial showed greater reduction in Hand Eczema Severity Index with a structured skincare program versus control, while a randomized cross over trial suggested fewer facial reactions with skin protectants under respirators, fit preserved under monitored conditions. Conclusions: Evidence supported modifiable risks, avoid hand rub on wet skin, reduce accelerator and latex exposure, optimize respirator fit and relief schedules, implement moisturization programs compatible with infection prevention.
subject: Articles
  topic: section
subject: Personal Protective Equipment, Healthcare Personnel, Dermatitis, Contact Dermatitis, Latex Hypersensitivity, Respiratory Protective Devices
  topic: keywords
creator: Fatema Abdulaziz Alsaleh¹, Sukinah Ali Alshowikhat², Layla Mousa Al Bashrowi³, Riham Nader Alghurab⁴, Alia Mahdi Almaidani⁵, Maryam Saeed Bawadi⁶, Mezharah Mohammed B. Al Makhalas⁷, Bushra Mohamed Alhamadi⁸
rights: Copyright (c) 2025 Medicina Katastrof
date: 2025-07-17
publication date: 2025-07-17

Vasopressor Strategy for Neuraxial Related Hypotension During CrashCesarean
type: item
description: Background: Crash cesarean requires rapid, reliable hemodynamic control. Neuraxial anesthesia frequently precipitates hypotension, therefore optimized vasopressor strategies are central to maternal safety and fetal perfusion. Methods: We conducted a systematic search of PubMed from inception to April 2024. Eligible studies were clinical trials or cohorts evaluating vasopressors for prevention or treatment of neuraxial related hypotension during crash or urgent cesarean. Two reviewers screened records, assessed risk of bias with appropriate tools, and extracted data in duplicate. The primary outcome was the incidence of maternal hypotension. Secondary outcomes were maternal bradycardia, nausea or vomiting, rescue vasopressor use, and neonatal Apgar scores and umbilical arterial pH. No meta-analysis was performed. Results: The search identified 547 records, 72 duplicates were removed, 475 titles and abstracts were screened, 45 full texts were assessed, and 10 studies were included (total n = 1150). Prophylactic infusions reduced hypotension compared with reactive bolus strategies, with absolute risk differences commonly between 30 and 70 percentage points across trials, for example 20% vs 90%, 31–37% vs 67%, and 15.5% vs 71.1. When active agents were compared, norepinephrine and phenylephrine maintained blood pressure similarly, while norepinephrine reduced maternal bradycardia relative to phenylephrine. Ephedrine was associated with more maternal nausea or vomiting, for example 22.2% vs 4.4% with phenylephrine. Neonatal outcomes, including umbilical arterial pH and Apgar scores, did not differ meaningfully across agents. Conclusions: In crash or urgent cesarean under neuraxial anesthesia, protocolized vasopressor infusions provided superior prevention of hypotension compared with bolus only approaches. Agent selection may be individualized, with phenylephrine or norepinephrine as first line and ephedrine reserved for selected physiologic profiles.
subject: Articles
  topic: section
subject: Cesarean section, Spinal anesthesia, Hypotension, Vasoconstrictor agents, Phenylephrine, Norepinephrine
  topic: keywords
creator: Shahad Abdulrahman Alawjan¹; Dalal Bader Almudehem²; Ayed Mulfi Ayed Almajdi³; Maram Eid Alharbi⁴; Nourah Hassan Alamri⁵; Sarah Bader Alanazi⁶; Hamad Salem Hamad Al Alshahi⁷; Amjad Awad Rahan Alyami⁸
rights: Copyright (c) 2025 Medicina Katastrof
date: 2024-06-16
publication date: 2024-06-16

Pharmacogenomic Guided Pain Management in Surgery: Patient PainOutcomes
type: item
description: Background: Postoperative pain remains common and variable across patients; pharmacogenomic guidance seeks to tailor analgesics to genotype to improve pain control and reduce opioid exposure. Methods: A systematic search of PubMed from inception to 28 Feb 2025 identified randomized and cohort studies in surgical populations where genotyping informed analgesic selection or dosing. The primary outcome was postoperative pain intensity within 24 to 72 hours on validated scales; secondary outcomes included opioid consumption converted to oral morphine equivalents, adverse events, and early recovery. Screening, extraction, and risk appraisal were performed in duplicate; findings were narratively synthesized. Results: Ten studies were included, four randomized trials and six cohorts. Pain effects were mixed. One arthroplasty trial reported lower mean pain over 10 days with genotype guidance, 3.1 vs 4.2 on a 0 to 10 scale, p<0.05, while a knee arthroplasty trial showed no difference at 24 hours, Overall Benefit of Analgesia Score 4.2 vs 4.7, p=0.55. A cohort within an enhanced recovery pathway showed better composite analgesia on postoperative day 1, 3.8 vs 5.4, and roughly 50% lower opioid use, p<0.01. Another randomized study observed lower two week opioid totals, median 200 vs 230 mg, p=0.047, with similar pain. In pediatric adeno- tonsillectomy, a COMT haplotype increased odds of opioid intervention, odds ratio 2.6, 95% confidence interval 1.2 to 5.4. Where reported, adverse effects were fewer with genotype guidance. Conclusions: Across surgical settings, genotype guided prescribing tended to reduce opioid consumption without worsening pain; effects on pain intensity were uncertain. Benefits appeared greatest when actionable phenotypes were targeted and recommendations were implemented reliably.
subject: Articles
  topic: section
subject: Pharmacogenetics, Pharmacogenomics, Postoperative pain, Analgesics, Perioperative care, Genotype
  topic: keywords
creator: Lyale Ali Abdullah Jalood¹; Lamia Saleh Aldossary²; Ola Saad Almutairi³; Eman Mohammed Busaleh⁴; Hawra Hassan Olaiwat⁵; Atiaf Faisal Alkhleef⁶; Rihanah Hassan Almahdi⁷; Naemah Rashed Bin Reshedan⁸
rights: Copyright (c) 2025 Medicina Katastrof
date: 2025-07-10
publication date: 2025-07-10

Influence of Abutment Retention Method on Dental Implant Prosthesis: Implant Stability and Screw Loosening
type: item
description: Background: Retention method for implant implant-supported crowns, screw retained or cement retained, may influence prosthesis stability and the risk of screw loosening, while implant survival typically remains high. Clarifying comparative mechanical outcomes can guide prosthodontic planning and maintenance. Methods: A systematic search of PubMed identified clinical trials and cohort studies from inception to 28 Feb 2025 comparing cement cement-retained with screw screw-retained restorations. Eligibility required human in in-vivo data reporting implant stability and screw loosening. Two reviewers screened, extracted data in duplicate, and assessed study quality. No meta meta-analysis was performed; results were synthesised narratively. Results: Ten studies met criteria followfollow-up 2–10 years). Implant survival was high and similar between groups across studies, typically 93–100 percent. Marginal bone changes were small and comparable; one 10-year comparison reported mean bone loss ~1.1 mm for both retention types. Screw loosening occurred more often in screw screw-retained restorations. A cohort reported loosening in 32 percent of screw screw-retained partial prostheses versus 9 per cent of cement cement-retained. A randomised posterior single single-crown trial observed 1 of 28 screw screw-retained crowns loosening (3.6 percent) versus 0 of 28 cement cement-retained at 24 months. External quantitative syntheses within the included evidence indicated lower rete ntionntion-failure risk for cement cement-retained designs (risk ratio 0.26; 95% CI 0.09 0.09–0.74 short term; pooled ~0.31 at ≥5 years). Secondary findings noted rare decementation with modern adhesive protocols and context context-dependent biological complications when excess c ement was not controlled. Conclusions: Choice of retention did not affect implant survival or bone stability; it chiefly altered the complication profile. Cement retention reduced screw loosening, whereas screw retention avoided…
subject: Articles
  topic: section
subject: Keywords: Dental implants, Dental abutments, Screw loosening, Cementation, Prosthesis retention, Treatment outcome
  topic: keywords
creator: Tamer Aljamaan¹; Ahmed Abdulrahman Almuashi²; Noura Adel Aldhamer³; Nourah Yahya Alkhaldi⁴; Maryam Abdullah Abdullah Alhmood⁵; Zakariya Ibrahim Ahmad Alsadah⁶
rights: Copyright (c) 2025 Medicina Katastrof
date: 2025-09-09
publication date: 2025-09-09

Nurse-Led Ultrasound at Point of Care (POCUS) in Emergency and Critical Care: Accuracy and Outcomes
type: item
description: Background: Nurse-led point of care ultrasound (POCUS) is increasingly used in emergency and critical care where rapid bedside diagnostics and procedural support are essential. Its accuracy and clinical impact across settings remain underexplored. Methods: We systematically searched PubMed and Scopus from inception to 28 February 2025 for clinical trials and cohort studies evaluating nurse-performed POCUS in adult and pediatric emergency or intensive care. Eligible outcomes included diagnostic accuracy, vascular or procedural success, and patient-centered metrics. Data were extracted in duplicate and synthesized narratively according to PRISMA guidelines. Results: Eleven studies (3 randomized trials, 8 cohorts) enrolling 50–302 participants each were included. Nurse FAST for trauma achieved sensitivity 84.4% (95% CI 72.1–92.2) and specificity 98.4% (94.9–99.6). Nurse lung ultrasound in dyspnea showed sensitivity 95.3% (92.6–98.1) and specificity 88.2% (84.0–92.4). For vascular access, ultrasound guidance increased first-attempt success (odds ratio 2.52; 95% CI 1.09–5.92). In arterial puncture, ultrasound reduced procedure time and complications compared with palpation. Management changes were reported in 26–84% of cases, particularly in fluid resuscitation and respiratory care. No study demonstrated mortality benefits, but adverse events were rare. Conclusions: Nurse-led POCUS demonstrated strong diagnostic accuracy, improved procedural success, and frequently informed management decisions across emergency and critical care. Wider adoption requires standardized training, competency assessment, and larger multi-center evaluations to determine patient-level outcomes.
subject: Articles
  topic: section
subject: Point-of-care ultrasound, nursing, Emergency medicine, Intensive care units, Diagnostic accuracy, Vascular access.
  topic: keywords
creator: Mohammed Ahmed Aljurayyad¹, Areej Ibrahim Alarani², Hassan Ali Al-Abdulghani³, Ashraf Ali Al Turaik⁴, Weam Amin Alramadhan⁵, Habib Ali Alkhwailidi⁶, Amal Salman Alawami⁷, Sukynah Muhammed Alabdullah⁸
rights: Copyright (c) 2025 Medicina Katastrof
date: 2025-05-25
publication date: 2025-05-25

Preventing Perioperative Hypothermia in Obstetric Surgery: A Systematic Review of Warming Methods During Cesarean Birth
type: item
description: Background: Perioperative hypothermia is a frequent complication during cesarean birth, associated with maternal shivering, discomfort, coagulopathy, and adverse neonatal outcomes. Effective prevention strategies are essential to improve obstetric surgical safety. Methods: We conducted a systematic review of PubMed, Embase, and Cochrane Library from inception to 28 February 2025. Eligible studies included randomized controlled trials or cohort studies evaluating active warming interventions during cesarean delivery under neuraxial anesthesia. The primary outcome was incidence of maternal perioperative hypothermia. Secondary outcomes included intraoperative temperature drop and maternal shivering. Two reviewers independently screened, extracted data, and assessed study quality. Narrative synthesis was applied given methodological heterogeneity. Results: Fourteen studies met inclusion criteria, enrolling 2,845 women across diverse geographic regions. Forced-air warming, warmed intravenous fluids, resistive heating, and multimodal combinations were assessed. Incidence of maternal hypothermia ranged from 20–65% in control groups compared with 5–25% in actively warmed groups, corresponding to a relative risk reduction of 35–55%. Combined forced-air and fluid warming was most effective, maintaining mean core temperatures within 0.3 °C of baseline. Maternal shivering occurred in 45–60% of controls versus 10–25% with warming interventions. Conclusions: Active warming methods effectively reduced maternal hypothermia and shivering during cesarean birth. Multimodal warming achieved the strongest protection and should be considered for routine implementation in obstetric anesthesia practice.
subject: Articles
  topic: section
subject: Cesarean section, perioperative hypothermia, obstetric anesthesia, warming methods, maternal outcomes, shivering.
  topic: keywords
creator: Haya Hadi Saleh Al Makhalas¹, Sohair Mosharea Rehan Alyami², Amjad Awad Rahan Alyami³, Mohammed Ahmed Almuqahwi⁴, Sara Yahya Hassan⁵, Wala Saeed Alshibar⁶
rights: Copyright (c) 2025 Medicina Katastrof
date: 2025-05-25
publication date: 2025-05-25

Radiation Exposure to Anesthetists During Interventional Radiology Procedures: A Systematic Review of Occupational Safety
type: item
description: Background: Anesthetists working in interventional radiology (IR) suites are positioned close to the patient, placing them at a unique risk of high scatter radiation exposure that is often underestimated compared to that of the primary operator. This systematic review aimed to synthesize the available evidence on the magnitude of radiation exposure to anesthetists during IR procedures and evaluate the effectiveness of occupational safety measures. Methods: A systematic search of PubMed, Scopus, and Embase was conducted to identify original studies that quantified ionizing radiation doses received by anesthetists during image-guided IR procedures. Following the PRISMA guidelines, two independent reviewers performed study selection, data extraction, and risk of bias assessment. Due to significant heterogeneity in procedures and dosimetry methods, a structured narrative synthesis was performed instead of a meta-analysis. Results: Twelve studies met the inclusion criteria. The review found that anesthetists' radiation exposure can be significant, with one study reporting head and neck doses up to 3.2 times higher than those of the primary neurointerventionalist. Mean effective doses varied widely by procedure. Exposure to unshielded areas, particularly the eye lens, was a major concern, with procedural doses that could contribute substantially to approaching annual limits. Conclusions: Anesthetists face a significant and procedure-dependent occupational radiation risk, which necessitates targeted safety protocols. Routine use of personal dosimeters, mandatory role-specific radiation safety training, and consistent use of personal protective equipment.
subject: Articles
  topic: section
subject: Radiation Exposure, Anesthesiologists, Interventional Radiology, Occupational Safety, Dosimetry
  topic: keywords
creator: Jalal Sadiq M. Alsaad¹, Dalal Mohammed Al Sadoon², Ahmed Mahdi Alawazim³, Saleh Abdulhadi Alamri⁴, Al-Hanoof Fahad Al-Zuraiq⁵, Huda Saeed Basaqr⁶, Reem Khalid Alshahab⁷, Alaa Abdulraouf Alsabbagh⁸
rights: Copyright (c) 2025 Medicina Katastrof
date: 2025-04-25
publication date: 2025-04-25

Efficacy of dexmedetomidine sedation by anesthesia technicians for pediatric MRI/CT procedures
type: item
description: Background: Pediatric magnetic resonance imaging (MRI) and computed tomography (CT) often require sedation to ensure diagnostic quality, yet traditional agents pose risks of respiratory depression and prolonged recovery. Dexmedetomidine, an alpha-2 adrenergic agonist, offers a favorable safety profile with minimal respiratory effects. In Saudi Arabia, the scope of anesthesia technicians administering sedation remains ambiguous. This systematic review evaluates the efficacy and safety of dexmedetomidine administered by trained anesthesia technicians for pediatric imaging. Methods: This systematic review followed PRISMA 2020 guidelines. Studies were identified through a comprehensive search of PubMed until 2025. Eligible studies included those reporting dexmedetomidine sedation administered by trained non-physician providers in pediatric patients undergoing MRI or CT. Data extraction and quality assessment were conducted independently by two reviewers. A narrative synthesis was performed due to heterogeneity among included studies. Results: Twelve studies involving 2,489 children were included. Reported sedation success rates ranged from 89% to 98%. The most common adverse events were transient bradycardia (5–15%) and hypotension (4–12%), which were self-limiting. No significant respiratory complications were observed. Non-physician-led sedation services demonstrated improved efficiency, with reduced imaging suite. Conclusions: Dexmedetomidine administered by trained non-physician providers is effective and safe for pediatric MRI and CT. Structured protocols can optimize sedation services and enhance workflow efficiency. Further multi-center prospective studies are warranted to strengthen the evidence base.
subject: Articles
  topic: section
subject: Pediatric sedation, Dexmedetomidine, Non-physician providers, MRI, CT imaging, Safety and efficacy, Anxiety
  topic: keywords
creator: Abdulaziz Awad Alshehri¹, Sukaina Hussain Alkhadimi², Abdullah Mohammed Saleh Almarhoon³, Nawal Saeed Salem Albakhit⁴, Haya Khalid Al-Musailem⁵ Anwar Mansour Ahmed Alkarnous⁶, Fadilah Salman Alwi Alawami⁷, Zainab Abdullah Jassim Aldawood⁸
rights: Copyright (c) 2025 Medicina Katastrof
date: 2025-05-25
publication date: 2025-05-25

Liver Determination of Length using Sonography: A Cross-sectional Study
type: item
description: Background: Ultrasound measurement of liver size is a critical component of abdominal assessment, providing key data for identifying hepatomegaly and other hepatic disorders. While international reference values for liver size are well-established, population-specific data from Saudi Arabia remain limited. This study aimed to establish normative sonographic liver measurements among healthy young male adults at Hail University and to evaluate their association with age, height, and weight. Methods: A cross-sectional study was carried out among thirteen healthy male students. Liver length was measured using B-mode ultrasonography in the midclavicular sagittal plane, applying a standardized protocol. Participants’ age, height, and weight were recorded. All examinations took place in the radiology department over a three-week period in November 2018. Data were analyzed using descriptive statistics and correlation methods to explore relationships between liver size and anthropometric variables. Results: The mean participant age was 28.4 years (SD 7.4), with a mean liver length of 13.7 cm (SD 1.26), mean weight of 75.1 kg, and mean height of 1.73 m. Sonographic evaluation showed normal hepatic echotexture and contour in all subjects, with no evidence of focal lesions or biliary abnormalities. No strong correlations between liver length and age, weight, or height were identified in this limited cohort. Conclusions: Sonographic liver length among healthy young Saudi males is consistent with international standards. Ultrasound remains a reliable, noninvasive tool for liver assessment. These results establish useful reference values for local clinical practice and future research.
subject: Articles
  topic: section
subject: Liver, Ultrasonography, Saudi Arabia, Reference Values, Anthropometry, Healthy Volunteers
  topic: keywords
creator: Hassan Saeed Alqahtani¹, Khioud Rashed Alkhaldi², Abdullah Kheder Algahamdi³, Balqis Mousa Alnooraldeen⁴, Jassem Mohammed Almosharaf⁵, Fatma Abdullah Aldossary⁶, Aliyah Alghamdi⁷, Maryam Mohammed Alharbi⁸, Omnia Saleh Umar Fallatah⁹, Hanan Saleem Alawad¹⁰, Rahaf Salm Mosaed AlMosaed¹¹
rights: Copyright (c) 2025 Medicina Katastrof
date: 2024-11-14
publication date: 2024-11-14

Diagnostic performance and patient outcomes of ultrasound use in trauma triage by Emergency Medical Services teams
type: item
description: Background: Rapid, accurate trauma triage is essential for improving patient outcomes in prehospital emergency care. Ultrasound use by Emergency Medical Services (EMS) teams may enhance early injury detection and guide critical prehospital decisions. This systematic review synthesizes evidence on diagnostic accuracy and patient outcomes associated with prehospital ultrasound (POCUS) in trauma triage. Methods: A comprehensive literature search till 2024 was conducted in PubMed, Scopus, and CENTRAL databases following PRISMA guidelines. Ten studies, including five prospective clinical trials and five observational cohorts, met the eligibility criteria. Diagnostic performance (sensitivity, specificity, predictive values), mortality, and other patient-centered outcomes were extracted and narratively synthesized. Results: Ultimately, 10 studies fully matched the inclusion criteria and were included in this review. Ultrasound sensitivity for detecting free intra-abdominal fluid ranged from 78% (95% CI: 72–84%) to 92% (95% CI: 88–95%), while specificity consistently exceeded 95% (95–99%). For pneumothorax detection, sensitivity was between 65% (95% CI: 58–72%) and 85% (95% CI: 79–90%), with specificities ranging from 94% to 98%. POCUS influenced triage decisions, reduced mean time to surgery by 25 minutes (95% CI: 15–35 minutes), but showed inconsistent effects on overall 30-day mortality (RR: 0.92, 95% CI: 0.78–1.09). Conclusions: Prehospital ultrasound demonstrated high diagnostic specificity and positively influenced triage decisions, though sensitivity varied. Further standardized protocols and training are required.
subject: Articles
  topic: section
subject: Ultrasonography, Emergency Medical Services, Trauma, Triage, Diagnostic Imaging, Patient Outcome Assessment.
  topic: keywords
creator: Mohamed Saleh Jaber AlYami¹, Hamad Zafer Saleh Al Aba Tahin¹, Sultan Salem Ali Al-Yami¹, Mohammed Muslih Bin Mohammed Al Sallum², Fahad Jaber Bn Hadi Al Saloom², Hamad Salem Hadi Al Handhal², Mesfer Faraj Ali Al Yami², Saif Sultan Saleem Al Harthi³
rights: Copyright (c) 2025 Medicina Katastrof
date: 2024-12-15
publication date: 2024-12-15

Impact of Shift Work and Long Working Hours on Sleep Quality and Clinical Performance Among Health Professionals
type: item
description: Background: Shift work and prolonged working hours are integral to modern healthcare; they maintain 24-hour service but disrupt circadian rhythms. These nonstandard schedules impair sleep quality and cognitive performance, potentially increasing clinical errors among health professionals. Understanding these effects is critical for workforce management and patient safety. Methods: A systematic search of PubMed from database inception through 2024 was conducted, adhering to PRISMA guidelines. Clinical-trial and cohort studies examining the impact of shift work or extended-hour schedules on sleep quality and clinical performance were eligible. Results: Across 14 included studies, night-shift or extended-hour conditions were associated with markedly increased error rates, including a 44 % relative increase in crossover trials and a 1.8-fold rise in error odds (95 % CI 1.3–2.5) in cohort analyses. Sleep metrics deteriorated under nonstandard schedules, with Pittsburgh Sleep Quality Index scores rising by approximately 3 points and average sleep time declining below 5 h, while task completion and dispatch times slowed by 12 % and 9 %, respectively, and simulated triage times increased by 18 %. Intervention studies demonstrated that planned 40-minute naps reduced psychomotor vigilance lapses by 37 % and that a telehealth-delivered sleep program improved PSQI scores by 2.4 points and reduced self-reported errors by 15 %. Conclusions: Nonstandard work schedules and extended shifts substantially compromise sleep health and elevate clinical error risk among healthcare professionals. Adoption of evidence-based countermeasures is imperative to mitigate fatigue, enhance practitioner well-being, and improve patient safety.
subject: Articles
  topic: section
subject: shift work, sleep quality, clinical performance, circadian rhythms, occupational health, patient safety
  topic: keywords
creator: Salem Hussen Mosfer Alsaad¹, Ojeam Mana Saleh Al Mutared², Wael Hamad Abdullah Al Jamhoor³, Fayez Salem Bin Mohammed Allabid⁴, Khaled Hassan Hadi Al Hokash⁵, Saleh Mohaimeed Saleh Al Sharmah⁶, Masoud Saleh Ahmed Al Haydar⁷, Yahya Ali Al Qanass⁸
rights: Copyright (c) 2025 Medicina Katastrof
date: 2024-11-13
publication date: 2024-11-13

Early-Warning Score Systems Supervised by Nurses and Their Impact on Quality of Healthcare
type: item
description: Background: Early-warning score (EWS) systems are designed to identify patient deterioration before critical events occur. When supervised by nurses, these systems may improve response time and outcomes, yet variability in implementation and effectiveness remains a concern. This review aimed to evaluate the impact of nurse-supervised EWS systems on healthcare quality outcomes. Methods: A systematic search was conducted in PubMed for studies published up to February 2025. Eligible studies included clinical trials and cohort designs evaluating EWS interventions supervised by nurses in hospital settings. Screening, data extraction, and risk of bias assessment were performed independently by two reviewers. Outcomes included mortality, cardiac arrest, ICU transfers, protocol compliance, and hospital stay. Results: Ten studies met inclusion criteria, comprising six cohorts and four trials from various regions including Saudi Arabia, Europe, and Asia. Electronic and manual EWS interventions led by nurses were associated with reduced in-hospital mortality (up to 1.3% absolute reduction), lower code blue events (relative reductions up to 85%), and improved protocol adherence (increased from 2.5% to 45.5%). ICU transfer and length of stay effects varied. Studies with combined digital platforms and escalation training showed the strongest results. Conclusions: Nurse-supervised EWS systems significantly enhance patient safety and clinical outcomes when implemented with structured escalation pathways and digital tools.
subject: Articles
  topic: section
subject: Early warning score, nursing supervision, patient safety, clinical deterioration, hospital mortality, rapid response.
  topic: keywords
creator: Majed Faiz Alasmari¹, Abdullah Ali Mufarrih Almalki², Khalid Musaad Alalyani³, Nawal Abdullah AlQarni⁴, Rawan Mohammed Al-amer⁵, Laila Ahmed Abdullah Al-Aqeel⁶
rights: Copyright (c) 2025 Medicina Katastrof
date: 2025-02-11
publication date: 2025-02-11

Continuous Versus Intermittent Fetal Oxygen Saturation Monitoring Under Regional Anesthesia
type: item
description: Background: Continuous fetal oxygen-saturation monitoring promises earlier recognition of intrapartum hypoxia during neuraxial analgesia; however, reported effects on operative birth vary and no synthesis has focused on regional practice gaps. Methods: A protocol was registered with PROSPERO. PubMed was searched from inception to 30 June 2024 combining MeSH and free-text terms for pulse oximetry, fetal monitoring, regional anaesthesia and labour. Randomised or cohort comparisons of continuous versus intermittent saturation monitoring were eligible. Two reviewers performed duplicate screening, data extraction and risk-of-bias appraisal (RoB 2 or Newcastle–Ottawa). Owing to methodological heterogeneity, results were synthesised narratively. Results: Thirteen studies met criteria, eight randomised trials and five prospective cohorts, together enrolling 9 274 parturients, of whom 5,316 received continuous monitoring. Four trials showed significant reductions in operative birth for non-reassuring fetal status (relative risk 0.31–0.77), whereas the two largest pragmatic trials were neutral. A saturation below 30 percent sustained for 10 minutes predicted umbilical arterial pH ≤ 7.15 with pooled sensitivity 92.9% and specificity 85 percent. No study reported excess infection; patient acceptability reached 92%; and one economic evaluation estimated savings of AUD 813 per operative birth averted. Conclusions: Continuous fetal pulse oximetry under regional anaesthesia accurately identifies prolonged hypoxia and can reduce intervention when paired with clear management thresholds; nonetheless, benefit is inconsistent and further context-specific trials, particularly in the Gulf region, are warranted.
subject: Articles
  topic: section
subject: fetal pulse oximetry, regional anaesthesia, intrapartum hypoxia, operative delivery, epidural labour, systematic review
  topic: keywords
creator: Majed Faiz Alasmari¹, Abdullah Ali Mufarrih Almalki², Khalid Musaad Alalyani³, Anwar Mazi Alfauri⁴, Alhanouf Mohammed Qaziz⁵ Hassan Rumayh Aldawsari⁶, Naji Mubarak Alsubaie⁷, Laila Ahmed Abdullah Al-Aqeel⁸
rights: Copyright (c) 2025 Medicina Katastrof
date: 2024-12-22
publication date: 2024-12-22

Enhanced Recovery After Surgery (ERAS) Pathways in Tertiary Hospitals: Effects on Post-operative Opioid Use and Length of Stay
type: item
description: Background: Enhanced Recovery After Surgery (ERAS) pathways attenuate surgical stress, accelerate convalescence and curb opioid exposure, yet their impact within tertiary hospitals, where comorbidity and baseline opioid use are greatest, remains unclear. Methods: PubMed, EMBASE, Scopus and CENTRAL were searched from inception to 31 May 2024. Randomised trials and cohort studies reporting postoperative opioid consumption and/or hospital length of stay (LOS) in adults treated in tertiary or teaching hospitals were eligible. Two reviewers performed duplicate screening, data extraction and risk-of-bias appraisal (RoB 2, ROBINS-I). Results: Of 2 148 records, nine studies met inclusion criteria (three trials, six cohorts; 56 004 patients). ERAS protocols incorporated multimodal analgesia, early mobilisation and accelerated feeding. Median inpatient opioid use fell by 40–54 % in trials and by 41–47 % in cohorts; a claims-based analysis showed the 180-day opioid-fill rate declined from 31.3 % to 20.9 % (rate ratio 0.53). LOS decreased by a pooled mean 1.7 days (range 0.8–3.5). No study reported higher Clavien–Dindo grade III–V complications or 30-day readmissions. Conclusions: ERAS pathways in tertiary hospitals consistently reduce opioid dependence and shorten LOS without compromising safety, delivering measurable fiscal and patient-centred gains. Wider adoption with rigorous compliance auditing and harmonised outcome reporting is warranted, particularly in under-represented regions and complex surgical populations. Future multicentre trials should also explore protocol adaptations for frail elderly and resource-limited settings.
subject: Articles
  topic: section
subject: Enhanced Recovery After Surgery, Opioid Stewardship, Length of Stay, Tertiary Hospitals, Systematic Review, Surgical Outcomes.
  topic: keywords
creator: Fahad Saud Alsubaie¹, Rashed Mohammed Aldawsari², Sulaiman Abdullah Alrakaf³, Abdullah Alkhaibari⁴, Mubarak Abdullah Almawash⁵ Hatim Mohammed Alanazi⁶, Nawaf Ali Ajeebi⁷, Hassan Faraj Alassari⁸
rights: Copyright (c) 2025 Medicina Katastrof
date: 2024-12-21
publication date: 2024-12-21

Integrating Virtual Reality and Artificial intelligence Tools to Optimize Interprofessional Coordination in Clinical Care
type: item
description: Background: Interprofessional coordination breakdowns contribute substantially to adverse events in clinical care, with up to 10% of hospital patients affected and millions of associated deaths worldwide. Emerging technologies—artificial intelligence (AI) and virtual reality (VR)—offer synergistic opportunities to enhance team communication, decision making, and workflow efficiency, yet their combined impact on multidisciplinary coordination has not been systematically evaluated. Methods: We conducted a systematic review of PubMed‐indexed studies published from January 2010 to December 2024. Eligible studies were randomized clinical trials or prospective cohort studies assessing integrated AI–VR interventions aimed at improving interprofessional coordination among pharmacy, nursing, dental, and midwifery professionals. Two reviewers independently screened titles, abstracts, and full texts; extracted data on study design, sample size, intervention characteristics, and outcomes; and appraised risk of bias using established checklists. Results: Seventeen studies (10 trials, 7 cohorts) met inclusion criteria. AI–VR interventions yielded moderate to large coordination gains (effect sizes d=0.65–1.10; odds ratio 3.4 for achieving high‐level teamwork). Error rates declined by 28–55%, and task completion times improved by an average of 12%. User satisfaction consistently exceeded 4.3 on 5-point scales. Follow-up data demonstrated retention of coordination improvements at 3 months (mean 82% of initial gain) and 6 months (68%). Implementation challenges included interoperability issues (56% of sites) and cognitive load concerns (47% of participants). Economic evaluations reported a mean return on investment within nine months, driven by 21% lower training costs and 17% fewer coordination-related adverse events. Conclusions: Integrated AI–VR tools produce robust, sustained improvements in interprofessional coordination, error reduction, and cost savings across diverse clinical…
subject: Articles
  topic: section
subject: Artificial Intelligence, Virtual Reality, Interprofessional Coordination, Systematic Review, Healthcare Simulation, Team Communication
  topic: keywords
creator: Dina Ali Mohammed Al-Hammadi¹, Maryam Rabiah Mohammed Al Rabiah², Zahra Habib Afreed³, Najebah Saleh Aboalrehi⁴, Alaa Abdulbasit Al Abdulbaqi⁵ Fatimah Hani Almashor⁶, Fatemah Saud Alshaik⁷, Mashael Abdulaziz Albarrak⁸
rights: Copyright (c) 2025 Medicina Katastrof
date: 2025-02-08
publication date: 2025-02-08

Evaluating Infection‐Control Practice Among Surgical, Anesthesia, and Radiology Teams
type: item
description: Background: Healthcare‐associated infections (HAIs) in perioperative and imaging settings pose substantial risks to patient safety. Anesthesia and imaging technologists are pivotal in infection prevention but often exhibit suboptimal compliance with protocols. This systematic review aimed to synthesize global and Saudi Arabian evidence on technologist adherence to infection‐control measures, identify effective interventions, and inform targeted strategies for improvement. Methods: We followed PRISMA guidelines to search PubMed and Embase from inception through December 31, 2024, supplemented by clinicaltrials.gov and reference‐list screening. Eligible studies were randomized clinical trials or cohort studies reporting quantitative compliance metrics among anesthesia or imaging technologists. Dual independent reviewers screened titles, abstracts, and full texts, extracted data using a standardized form, and assessed risk of bias with the Joanna Briggs Institute and Cochrane RoB 2.0 tools. Results: Fourteen studies (six trials, eight cohorts; total N≈1,365 technologists) met inclusion criteria. Baseline composite infection‐control compliance averaged 54.6% (range 18.0%–78.9%), with lower hand‐hygiene rates in anesthesia technologists (mean 45.3%) versus imaging technologists (61.8%; p<0.01). Multimodal interventions—combining direct observation, real‐time feedback, peer coaching, and refresher training, yielded mean compliance improvements to 68.2% at 6‐month follow‐up. Secondary outcomes included knowledge score increases, and decreased needlestick injuries in anesthesia staff (IRR 0.26). Conclusions: Infection‐control compliance among anesthesia and imaging technologists remains below recommended thresholds but can be substantially improved through sustained, multimodal interventions. Directly observed composite adherence rates serve as a robust primary outcome for benchmarking. Embedding continuous audit‐and‐feedback mechanisms, fostering supportive organizational …
subject: Articles
  topic: section
subject: Infection Control, Anesthesia Technologists, Imaging Technologists, Compliance, Healthcare‐Associated Infections, Audit And Feedback
  topic: keywords
creator: Hussain Mousa Ahmed Jaafari¹, Maryam Abdrabalrasool M. Obaidi², Afrah Mohammed Ali Alzaki³, Manal Ibrahim M. Al Sawad⁴, Afaf Saud Saeed Alshahrani⁵ Yousef Ahmed Al Rashed⁶, Fatimah Ahmed AlJaroodi⁷, Zahiah Abdualrahman Alhamad⁸
rights: Copyright (c) 2025 Medicina Katastrof
date: 2025-02-07
publication date: 2025-02-07

Effectiveness of National Reporting Systems in Capturing Adverse Drug Events Across Healthcare Cadres
type: item
description: Background: Adverse drug events (ADEs) are a leading cause of preventable patient harm worldwide. National pharmacovigilance systems play a critical role in detecting and mitigating ADEs; however, their effectiveness varies, especially in capturing reports from all healthcare professionals including nurses, physicians, and pharmacists. Methods: This systematic review followed PRISMA 2020 guidelines. A comprehensive search was conducted in PubMed for studies published from 2010 to 2024 using combinations of MeSH terms and keywords related to ADE reporting systems and healthcare personnel. Studies were included if they evaluated national ADE reporting mechanisms involving healthcare workers. Data extraction and risk of bias assessment were performed independently by two reviewers. Meta-analysis was not conducted due to heterogeneity. Results: Fifteen studies met the inclusion criteria, comprising both clinical trials and cohort studies. Interventions evaluated included educational programs, EHR-linked reporting tools, mobile apps, and pharmacist-led detection. Detection rates of ADEs improved significantly in studies using multifaceted interventions, with some reporting a fivefold increase post-intervention. However, passive strategies like email alerts showed minimal impact. Secondary outcomes included report quality, sustainability of reporting, and staff engagement. Pharmacists consistently contributed the most ADE reports, but underreporting persisted across all cadres. Limited local engagement was evident in Saudi Arabia, despite structured systems. Conclusions: Active, multidisciplinary interventions significantly enhance the effectiveness of national ADE reporting systems. Sustained improvements require ongoing education, system integration, and supportive institutional policies. There is a critical need to engage all healthcare professionals, particularly in low-reporting regions like Saudi Arabia.
subject: Articles
  topic: section
subject: Pharmacovigilance, Adverse Drug Event, Reporting Systems, Healthcare Professionals, Saudi Arabia, Medication Safety
  topic: keywords
creator: Mathayl Hussain Alqahtani¹, Fatemah Ahmed Mohammed Al Hamdan², Ayat Jawad Al Lashet³, Ahmad Dhafer Alwehaimid⁴, Fatimah Hassan Ahmed Alsabbagh⁵, Hawra Ahmed Alali⁶
rights: Copyright (c) 2025 Medicina Katastrof
date: 2025-02-05
publication date: 2025-02-05