عن المجلة مجلة Journal of Tazeez for Public Health هي مجلة علمية محكّمة متخصصة في مجال الصحة العامة، تصدر تحت مظلة الجمعية السعودية للتعزيز والتثقيف الصحي بجامعة الملك سعود، وتهدف إلى دعم البحث العلمي ونشر المعرفة المتخصصة في مجالات تعزيز الصحة، التثقيف الصحي، والوقاية من الأمراض، بما يسهم في تطوير الممارسات الصحية وتحقيق مستهدفات رؤية المملكة 2030. وقد صدر اعتماد المجلة رسميًا بموجب قرار مجلس جامعة الملك سعود رقم (4/7) وتاريخ 27/04/1441هـ، والمتضمن الموافقة على إنشاء الجمعية السعودية للتعزيز والتثقيف الصحي، والتي تعمل المجلة تحت مظلتها وفق الأنظمة واللوائح المنظمة للجمعيات العلمية في الجامعات السعودية. تسعى المجلة إلى أن تكون منصة علمية رائدة لنشر الأبحاث الأصيلة، والمراجعات العلمية، والدراسات التطبيقية ذات الأثر في مجال الصحة العامة، محليًا وإقليميًا ودوليًا، مع الالتزام بأعلى معايير التحكيم العلمي والأخلاقيات البحثية. لمزيد من المعلومات عن الجمعية السعودية للتعزيز والتثقيف الصحي، يرجى زيارة الموقع الرسمي: https://tazeez.ksu.edu.sa (موقع الجمعية والأنشطة العلمية)
FAST versus CT for detecting intra-abdominal injury in hemodynamically stable patients after motor vehicle collisions: a systematic review
Background: In hemodynamically stable patients after motor vehicle collisions (MVCs), rapid detection of intra-abdominal injury (IAI) is important to avoid missed injuries. FAST (Focused Assessment with Sonography for Trauma) is a widely used method for bedside screening, and computed tomography (CT) is the principal for evaluation. We aimed to systematically review the data comparing FAST with CT for detection of IAI in hemodynamically stable patients after MVC related blunt abdominal trauma. Methods: our study is A PRISMA based systematic review and our literature search was applied in PubMed, Scopus, and Web of Science. We screened free original studies about FAST in blunt abdominal trauma, with CT and clinical reference standards. A set of 10 original studies were included, cohorts focused on hemodynamically stable blunt trauma and motor vehicle accident populations. Data extraction was done and we extract the study design, population characteristics, hemodynamic status, comparator standard, and diagnostic outcomes. Results: The identified studies were heterogeneous in design, trauma mechanism, age group, and outcome definitions. FAST show a value as a rapid bedside triage tool, but limitations were noted in excluding all IAIs, mainly low volume bleeding and gastrointestinal injuries. CT is the most comprehensive modality for injury detection and characterization in stable patients. Conclusion: FAST is complementary early assessment tool rather than a standard substitute for CT in hemodynamically stable MVC patients with suspected IAI.
Copyright (c) 2026 Mazi Mohammed Alanazi, Abdulkarim Mohammed Alharbi, Atikah Thamer Kadi (Author)
Management of traumatic hemothorax: thresholds for chest tube insertion and outcomes; systematic review
Background: Traumatic hemothorax is common after blunt and penetrating chest trauma. With routine CT imaging, small and occult hemothoraces are detected more frequently, creating doubt about when to observe or insert a chest tube and how those choices affect outcomes. We aimed to synthesize original articles on radiologic and clinical thresholds associated with chest tube insertion for traumatic hemothorax and outcomes related to drainage strategy and escalation. Study eligibility: Original clinical studies (randomized or observational) of traumatic hemothorax and hemopneumothorax that reported drainage decisions, thresholds, or outcomes. Methods: our study followed PRISMA guided screening, data extraction, and qualitative synthesis, meta-analysis performed where two or more studies reported comparable outcomes. Primary meta-analysis outcome were needed for VATS after initial drainage in small bore vs large bore drainage strategies. Results: Ten original studies were included, CT based hemothorax depth was associated with drainage decisions, in one cohort >3 cm thickness was drained, while 2 cm was a decision inflection point. In the ventilated trauma patients with occult hemothoraxa and hemopneumothorax, greater CT thickness correlated with tube placement. Delayed hemothorax is uncommon but clinically relevant, readmission for delayed hemothorax after rib fracture observed in 0.26% in a large database study. In meta-analysis, small-bore drainage showed no clear difference in VATS compared with larger bore tubes (RR 0.87, 95% CI 0.47 - 1.60). Conclusion: CT depth is the most reproducible radiologic threshold informing tube insertion decisions, while delayed hemothorax is uncommon but require drainage and operative escalation when it occurs. Small bore drainage strategies did not show a higher VATS requirement in pooled analysis, though articles remains limited and context dependent.
Copyright (c) 2026 Mazi Mohammed Alanazi, Abdullah Nasser Shablahah, Mohammed Yahya M alalkami (Author)
Effectiveness of Doppler Indices in Predicting Adverse Perinatal Outcomes in Early and Late-Onset FGR: Systematic Review
Background: Doppler velocimetry guides monitoring in fetal growth restriction (FGR), and the most informative index differ by early- vs late-onset disease. We aimed to evaluate Doppler indices to predict adverse perinatal outcomes in early- and late-onset FGR. Methods: We searched online databases and screened full-text original studies linking Doppler measures with perinatal outcomes in FGR. Data were extracted on design, sample size, FGR, onset definitions, Doppler markers, outcome composites, and predictive performance, AUC, sensitivity, and specificity. Findings were analyzed qualitatively, because thresholds and outcomes varied. Results: we include nine observational studies. Common markers were UA-PI, MCA-PI, uterine artery PI, and ratios; some studies assessed composite measures. Late-onset cohorts found moderate to high discrimination for selected predictors, whereas larger cohorts showed modest performance for UCR and CPR thresholds. Abnormal UA Doppler was more sensitive than low CPR for predicting SGA, with similar specificity. Early abnormal UA Doppler identified higher stillbirth risk but had low sensitivity. Conclusion: Doppler indices aid risk grouping in FGR, but accuracy varies by onset phenotype, marker choice, and outcome definition; we need standardized thresholds and outcome sets in practice.
Copyright (c) 2026 AlHussain Sagr Al Hazmi, Aisha Ahmad N Qumiri ‎‏, Doaa Walid Abdulfattah, Babiker Mhgoub Babiker Abdoon, Hussam Salem Alshammari, Hajar Rida M Almoqbel, Afnan Mgbel, Bushra Ali S AlGhamdi, Saeed Tariq Saloom, Faisal Talal Alsharif, Rawabi Almarri, Saad Khaleel Alonze (Author)
A Systematic Review of Ultrasonography for the Diagnosis of Soft Tissue and Skin Abscesses in Emergency Departments
Background: Skin and soft tissue infections are among the primary causes of ED visits for patients. We set out to determine the diagnostic accuracy of ultrasonography in the diagnosis of soft tissue and skin abscesses in emergency department. Method: Our study meets the PRISMA requirements and was conducted in accordance with best practice principles. We searched PubMed, Scopus, Google Scholar, and the Cochrane database of controlled trials to locate publications published between 2016 and 2023. We reviewed the available bibliographies for the studies and examined the articles to make sure nothing was missed. Result and conclusion: Five studies total, four in the ED and one in the clinic, were included in this systematic review. Four ultrasound investigations were conducted by emergency medicine experts, and one ultrasound investigation was conducted by family practice and internal medicine specialists. According to the included research, cellulitis abscesses may be reliably diagnosed by ultrasonography. Providers should consider using ultrasonography into their diagnostic examination of skin and soft tissue infections when there is a clinical question.
Copyright (c) 2026 Mazi mohammed Alanazi, Abdulrahman Masmali, Ali Abdulrahman Alahmari (Author)
Dental perioperative nursing practices and their effect on patient safety and recovery: a systematic review
Background: Dental surgery ranges from outpatient implant procedures under local anesthesia to complex oncologic resections requiring inpatient perioperative pathways. In this spectrum, perioperative nursing practices (psychological support, education, infection prevention, and structured oral-care pathways) required to reduce complications and improve recovery related outcomes. We aimed to synthesize open-access evidence on perioperative nursing practices in dental surgery and their effects on patient safety and recovery. Methods: A PRISMA aligned systematic review approach was drafted. Open access databases were targeted, focusing on perioperative nursing interventions in dental, oral surgical care. Eligible studies included randomized or non-randomized original research evaluating nursing delivered perioperative practices with patient safety or recovery outcomes. Data were synthesized due to heterogeneity in interventions and outcomes. Results: Included studies clustered into: perioperative psychological, comfort interventions around implant surgery, extended care education, coaching after implants, infection prevention quality improvement in dental clinical areas, and comprehensive perioperative nursing bundles in oral cancer surgery. Interventions were associated with improved anxiety, pain measures, better self-efficacy and peri implant indices, and signals toward reduced complications or improved perioperative stability. Conclusion: Open-access evidence supports practical perioperative nursing strategies, especially structured psychological support and post procedure coaching, education as contributors to safer dental surgery and improved recovery indicators.
Copyright (c) 2026 Huriyyah Sanad AlHafi, Fawzayh Sanad AlHafi (Author)
Early Defibrillation for Ventricular Fibrillation Cardiac Arrest in the Emergency Department; Systematic Review
Background: Ventricular fibrillation (VF) and pulseless ventricular tachycardia (pVT) are time sensitive cardiac arrest rhythms where survival depends on rapid defibrillation. In the emergency department (ED), both out of hospital cardiac arrest (OHCA) arrivals and in ED and in-hospital cardiac arrest (IHCA) events may be encountered. The ED specific evidence base on early defibrillation is limited in ED cohorts and broader in hospital registries. Objective: our study aim to analyze original articles from PubMed Central on the association between early defibrillation and outcomes in VF and pVT cardiac arrest managed in ED settings. Methods: We followed PRISMA methods, structured question, reproducible search strategy, eligibility criteria, dual stage screening, standardized extraction, and narrative synthesis. We searched electronic databases for full-text on December 2026 for studies reporting VF and pVT arrests with a measurable defibrillation time variable (time to first shock, defibrillation within 2 minutes, or rhythm analysis before arrest team arrival). We included original human studies and excluded reviews, editorials, simulations, and single patient case reports. Results: Ten original studies met inclusion criteria, in ED-managed arrests, time to first defibrillation differ widely (median 2 to 3 minutes in one ED cohort with survivors vs non-survivors showing similar times, and 10 to 12 minutes in shockable cases in another ED based study). In a large adult IHCA registry analysis, defibrillation within 2 minutes was associated with better longer term survival reported as a 49% higher likelihood of 1 year survival. A pediatric IHCA registry analysis found no significant association between defibrillation time and survival to discharge. In Danish hospitals, rhythm analysis before cardiac arrest team arrival was associated with higher ROSC. Conclusion: our finding prioritize rapid defibrillation for VF/pVT, with strong adult in hospital registry signals favoring very early shocks (≤2 minutes), while ED-specific cohorts show variable timing and outcomes. Pediatric in-hospital data indicate that timing effects differ by age group or clinical context. Higher-quality ED-specific prospective studies were needed.
Copyright (c) 2026 Mazi Mohammed Alanazi, Luay Fuad Almulaifi, Abdulrahman Mohammed Ghabban (Author)
Trends in Cesarean Section Rates and Indications over the Last 5 Years in a Tertiary Center
Background: Cesarean section (CS) is necessary and lifesaving in certain situations, but many tertiary centers report high and increasing use. Objective: To discuss articles on CS rates and indications in tertiary hospitals over the last five years. Methods: A PRISMA guided systematic review was conducted. We included English language, record based observational studies from tertiary centers reporting CS rates or indications with data covering at least one year within a recent five year window. We extracted data including (setting, study period, sample size, CS rate, indications, emergency and elective status, and Robson Ten-Group contributions). Findings were qualitatively synthesized. Results: Eight studies from Africa and Asia were included. CS rates ranged from 21.6% to 55.0%. One study reporting time points found increasing CS rates and rising maternal request CS. Where indications were reported, previous cesarean, uterine surgery and fetal distress were most frequent, while failure to progress and mal presentation also recurred. Four studies applied the Robson classification; Group 5 was the leading contributor. Conclusion: Recent tertiary center study found high CS rates, commonly driven by repeat CS and fetal status indications. Robson based audit and targeted efforts to reduce avoidable primary CS should be considered to improve safety and reduce variation.
Copyright (c) 2026 Fawaz Eldirdiri S Mohmed, Reem Khalid Alanazi, Norah Khalid Alosaimi, Rawan Ahmed I Haimed, Maram Ahmed K Enani, Dalia Magdy M Muhammad, Yazed Ahmad almahalawi, Bassam Mohammed Alnaimi (Author)
Emergency Department Outcomes Following Acute Asthma Exacerbations in Children: A Systematic Review
Background: Emergency Department (ED) presentations for acute asthma are a major driver of pediatric hospital admissions. Clarifying admission risk factors can guide disposition decisions and targeted prevention. Methods: We systematically searched MEDLINE, Embase, CINAHL, and PsycINFO from inception to the final search date, following PRISMA guidance. We included studies enrolling children and adolescents with physician-diagnosed asthma presenting with acute exacerbations to the ED and reporting hospital admission outcomes. Screening, data extraction, and risk-of-bias assessment were performed independently in duplicate. Results: Eight eligible studies from diverse settings (United States, United Kingdom, Italy, Egypt, and Saudi Arabia) were included. Consistently reported admission predictors encompassed uncontrolled baseline asthma, hypoxemia at presentation (SpO₂ <90%), low peak expiratory flow at 1 hour, and clinical severity scores. Demographic and social determinants, female sex in some cohorts, minority ethnicity, and socioeconomic deprivation—were associated with higher admission probability. Modifiable factors included excess short-acting β₂-agonist use, poor adherence to controller therapy, lack of follow-up, and exposure to tobacco smoke and indoor allergens. Viral infection was the most common precipitant. Across mixed-age datasets, a meaningful proportion of ED visits resulted in admission, underscoring opportunities for risk stratification and early intervention. Conclusions: Pediatric ED admissions for acute asthma reflect an interplay of clinical severity and social determinants. Optimizing controller use, reducing environmental exposures, and ensuring structured follow-up—alongside objective ED reassessment (oxygen saturation and early PEFR) reduce avoidable admissions and improve outcomes.
Copyright (c) 2025 Hadeel Alshammri, Maitha Almousa, Fahad Delyem Alkahtani, Khalid Mohammed Alenazi, Mohamad Faisal Aldhawi, Arwa Mohammed Bin Bakheet, Faheem Mohammed Alanazi (Author)
Nurse-led discharge planning, education, and telehealth interventions for improving self-management, quality of life, and adherence in chronic illness: systematic review
Background: Nursing techniques include respiratory rehabilitation, early detection of decompensation signs, palliative care, inhalation medication management, health education, and supporting healthy lifestyles. This review set out to examine the impact of nurse-led hospital or community interventions on the treatment and follow-up of COPD patients. Method: systematic review was carried out in compliance with the PRISMA guidelines. A systematic search was performed for articles published between 2013 and 2016 using the PubMed, Web of Science, and Embase databases. Results and conclusion: The process of discharge planning for COPD patients is effective in increasing the patients' knowledge of the disease and their own well-being. Both inhaler proficiency and adherence to nurse-driven inhaler instruction showed improvement. Evaluating how well the patients utilize inhalers is necessary to determine their educational limitations. A nurse-led telephone intervention is feasible in primary care and may improve patients' health and quality of life. It has not been demonstrated that walking at home with a phone mentor increases exercise capacity. Nurses may employ the PR program to support patients with their discharge plans and to enhance their self-efficacy ratings on all subscales for adults with COPD. Conclusion: Discharge planning process for COPD patients works well in raising the patients' level of awareness about the condition and their quality of life. Positive results were obtained in terms of inhaler proficiency and compliance with nurse-driven inhaler education.
Copyright (c) 2024 Yasmeen Hmoud Alshammari, Sarah Mansour Duhaim Aldawsari, Amjad Adnan Said Alharbi, Noura Abdullah Aldosari, Basmah Abdullah Aldossari, Amal hamed sughayyir, Basil Mohammed Alsalamah, Fahad Ali Aati (Author)
Respiratory Therapist Driven Ventilator Bundle Adherence And Patient Outcomes: Lung Protective Ventilation, Sedation Coordination, Oral Care, And Proning Implementation
Background: Respiratory therapist (RT) driven ventilator bundles promote lung-protective ventilation, sedation, oral care, VAP prevention, and proning coordination. We evaluated whether adherence to these elements is linked to better outcomes in mechanically ventilated adults. Methods: We systematically reviewed original studies identified from electronic databases. Eligible studies include ventilated adults and evaluated an RT-driven or RT-integrated bundle element, reporting adherence or clinical outcomes. Two reviewers screened and extracted data, and findings were synthesized narratively by bundle domain. Results: Eight studies met inclusion criteria in emergency department and ICU settings. Lung-protective ventilation initiatives improved adherence; some cohorts reported lower mortality and more VFD. ICU liberation approaches were associated with fewer delirium, early VAP events and shorter ventilation duration. VAP bundle audits showed higher compliance with lower VAP rates. Conclusion: RT-driven bundle adherence aligns with improved patient centered outcomes, although effects differ by component and study design. Standardized adherence definitions and risk adjusted evaluations are needed.
Copyright (c) 2025 Alaa Ahmed Alqattan, Reem Dhafer Alahmari, Waad Mohammed Hajib, Zahra Anwar Almarhoon, Yara Anwar Almutairy, Lamya Dhaifallah Alnakhli, Yahya Abdullah Otaif, Mashael Abdulrahman Mahzari (Author)
Ultrasound Guided Suction Evacuation for Cesarean Scar Ectopic Pregnancy: Effectiveness, Safety, Hemostasis Strategies, and Comparative Outcomes in a Systematic Review
Background: Cesarean scar pregnancy (CSP) carries substantial hemorrhagic risk and threatens future fertility. Ultrasound guided suction evacuation (UGSE), often with immediate balloon tamponade, is used as a uterus conserving option. In this study we aimed to synthesize original studies evaluating the effectiveness and safety of UGSE for CSP. Methods: We performed a PRISMA aligned review of original studies of UGSE for CSP. Eligible designs included retrospective or prospective cohorts and case series that reported procedural success, hemorrhage control measures, transfusion, major complications, β-hCG resolution, and short-term recovery. Meta-analysis was not attempted because of heterogeneity. Results: Ten original studies (from 2014 to 2025) met inclusion criteria. Most enrolled hemodynamically stable first trimester CSP and performed continuous ultrasound guidance with flexible cannulas; many used routine Foley catheter tamponade after evacuation. In studies, procedural success was high and severe complications uncommon. Series that standardized balloon tamponade reported particularly low rates of additional interventions and short hospital stays. Some comparative cohorts suggested similar or improved primary success for UGSE versus hysteroscopic assisted evacuation, with low transfusion needs overall. Where reported, β-hCG normalized within weeks. Conclusions: In appropriately selected early CSP managed by experienced teams, UGSE, especially with immediate balloon tamponade, achieves high success with favorable safety and recovery profiles. Structured peri operative protocols (readiness for hemostasis and adjuncts) appear integral to outcomes.
Copyright (c) 2025 Raghad Mohammed Binsaeed, Suha Hashim Hassan Elsayed, Ibtesam Fawaz Alshammari, Noman Abdulhameed Khan, Amber Abdulhameed Khan (Author)
Sepsis in Saudi Arabian acute care settings, a systematic review of epidemiology, prognostic markers, antimicrobial management, and prediction models
Background: Sepsis is a primary driver of in-hospital mortality. Guideline driven bundles have not eliminated outcome variability in settings, and significant implementation challenges persist. Objectives: This review synthesizes Saudi and regional studies regarding sepsis epidemiology, prognostication, antimicrobial timing, stewardship, and the performance of prediction models in emergency and ICU settings. Methods: We conducted a PRISMA aligned systematic review, searching electronic databases for adult studies in acute care hospitals. Eligible designs (observational cohorts, quality-improvement reports) were required to report mortality, ICU admission, organ support, length of stay, or model performance (discrimination, calibration). Two reviewers screened, extracted data, and assessed bias. Significant heterogeneity necessitated a narrative synthesis. Results: Ten studies met inclusion criteria. High ICU mortality from septic shock was a consistent finding. Both comorbidity and dynamic laboratory markers (platelet trajectories) had strong prognostic value. Evidence comparing antimicrobial timing (less than 1 hour versus 1-3 hours) in the ED was heterogeneous post adjustment. We also identified significant operational barriers to culture guided de escalation. Prediction models showed reasonable discrimination but variable calibration, requiring local validation before use. Conclusions: Key gaps identified include strengthening stewardship, HAI prevention, and the cautious, validated-only use of predictive models. Priorities for future work include standardized definitions and prospective multicenter evaluations.
Copyright (c) 2025 Omar Rayyan Omar Barayyan, Muath Ahmed Awad Alahamdi, Muaz Zafer Alquarny, Manal Saleh Alhazmi, Anouf Fawzi Enani (Author)
Tele health Nursing Models in Virtual Hospitals: Effects on Patient Outcomes, Safety, and Service Efficiency in Outpatient, Critical Care, Medical Consultation, and Mental Health Services; A Systematic Review
Background: Telehealth enabled virtual hospitals are increasingly used to extend nursing care in outpatient follow-up, critical care, medical consultation, and mental health services. Studies found benefits for outcomes, safety, and efficiency, but effects differ by model and setting. Objective: To systematically review telehealth nursing models in virtual hospitals and evaluate the effects on patient outcomes, safety indicators, and service efficiency in major service lines. Methods: We conducted a systematic review of original studies according to PRISMA guidelines to evaluate nurse-involved telehealth models. Eligible designs included randomized trials and observational studies reporting at least one domain outcome (clinical outcomes, safety, or efficiency). Two reviewers independently screened records, extracted data, and assessed risk of bias using RoB 2 or ROBINS-I. Results were synthesized by service line and outcome domain. Results: Included studies covered nurse-led outpatient telemonitoring, transitional care, tele-ICU support, and telemental health care management. Telehealth nursing models were associated with reductions in readmissions and emergency visits in transitional care, improvements in symptom control and quality of life in chronic disease programs, and lower mortality or shorter ICU length of stay in tele-ICU contexts. Patient satisfaction and acceptability were positive. Conclusion: Telehealth nursing models in virtual hospitals improve outcomes and efficiency while supporting safe, continuous care. We need standardized reporting of safety indicators and implementation fidelity.
Copyright (c) 2025 Bashayer Hijab Alanizi, Meshari Dhaifallah Albaqami, Sulaiman Ali Alshareef, Waleed Alhassan Siraj, Noof Ali Ameri, Faisal Khamis Alshammari, Ayidh Saud Alqahtani, Suaad Mohammed Alrowaily, Shahad Nahis Almutairi, Reema Abdullah Alfawzan, Mohammed Nasser Altaif (Author)
Opioid-free and opioid-sparing anesthesia for postoperative pain management: systematic review
Background: Opioid-free anesthesia (OFA) and opioid-sparing anesthesia (OSA) reduce postoperative opioid exposure and maintain analgesia and recovery quality. Methods: We conducted a PRISMA guided systematic review of original comparative studies evaluating OFA, OSA versus opioid-based anesthesia. We searched major biomedical databases and trial registries for adult surgical patients receiving general anesthesia. Outcomes include, postoperative pain scores, opioid consumption, rescue analgesia, postoperative nausea and vomiting (PONV), and quality of recovery measures. Two reviewers screened studies, extracted data, and assessed risk of bias independently. Results: we include 6 randomized controlled trials in laparoscopic cholecystectomy, gynecologic laparoscopy, video assisted thoracic surgery, bariatric surgery, breast surgery, and hysterectomy. OFA, OSA regimens commonly incorporated dexmedetomidine with ketamine, esketamine and, or intravenous lidocaine, often within multimodal pathways. Compared with opioid based anesthesia, OFA, OSA reduced PONV or antiemetic requirements. Effects on pain intensity and postoperative opioid use were variable: several trials reported lower early rescue analgesia and, or reduced morphine equivalent consumption, whereas others showed no significant differences. Conclusion: OFA, OSA were reliable for reducing opioid related adverse effects, mainly PONV, and support faster functional recovery. Analgesic benefits are protocol dependent. Standardized regimens and outcome reporting are needed to identify patients and procedures most likely to benefit.
Copyright (c) 2025 Tariq lutfi Jilani, Abdurahman Talal Bahha, Abdullah Alhashmi Alameer, JEHAD RAMZI S ALSAEDI, MOHAMMED ABDULLAH S ALZAHRANI (Author)
Radiographer targeted education to reduce repeat exposure in routine chest digital radiography
Background: Repeat and reject images in routine chest digital radiography increase patient dose and workload. International benchmarks recommend very low repeat rates, still local audits report higher figures. Improving radiographer performance is a plausible lever for reduction. We aimed to evaluate whether radiographer targeted education and related workflow strategies reduce technically avoidable repeats in routine chest radiography. Methods: we conducted a PRISMA aligned systematic review of electronic databases (MEDLINE, PubMed, Embase, Scopus, Web of Science, and CINAHL, CENTRAL) from 2012 to 2025. Eligible designs assessed radiographer focused interventions (education modules, checklists, communication aids, QI bundles) against usual practice or pre intervention periods. Primary outcomes were repeat and reject rate or extra images; secondary outcomes included image acceptance and operational effects. Risk of bias was appraised with ROBINS-I, JBI, and NIH tools. Heterogeneity precluded meta-analysis; a structured narrative synthesis was performed. No prospective registration. Results: Six studies met inclusion criteria, including multi hospital quasi experimental programs, single site QI bundles, and an observer study. Education modules improved knowledge, motivation, and skills with significant, sustained reductions in repetition. A chest radiography bundle lowered extra frontal images from 4.6% to 3.3% (p=0.001). A multilingual instruction protocol improved inspiration quality, cutting poor inspiration rejects from 26% to 9% and increasing fully inspired images from 57.8% to 92.3%. An observer study showed radiologists accepted images more often than radiographers, indicating value in harmonized acceptance criteria and feedback. Conclusions: Radiographer targeted education, simple checklists, and language appropriate patient instructions reduce technically avoidable repeats in routine chest radiography.
Quality Improvement; Positioning Checklists
Damage-Control Surgery Versus Early Definitive Management in Pediatric and Adolescent Trauma: A Systematic Review of Outcomes and Strategies
Study aim: we aimed to explore whether damage control strategies, damage control laparotomy, surgery (DCL, DCS) and damage control orthopedics (DCO), improve outcomes compared with early definitive surgery and early total care (EDS, ETC) in injured children and adolescents. Methods: We performed a systematic review of eight original studies (national databases, registries, single-center cohorts, an audit, a technique series, and a case report) including pediatric and adolescent trauma patients who required operative care. Reported outcomes included mortality, complications, length of stay (LOS), open-abdomen closure, and health-care use. Owing to heterogeneity, we used narrative synthesis and qualitatively appraised risk of bias. Results: Among children needing urgent laparotomy, DCL was used in 12–15% and was chosen for patients with worse physiology and higher injury severity. Compared with definitive laparotomy, DCL showed higher crude mortality (9% vs 2%) and longer LOS (17 vs 8 days), reflecting confounding by indication. In a national cohort of traumatic brain injury with femur fracture, DCO (15%) was associated with higher adjusted odds of inpatient death and resource use than ETC. Modern pediatric open-abdomen series reported high survival (93%) with primary fascial closure achievable in many cases, though prolonged open abdomen increased infection risk. Conclusions: In pediatric trauma, DCL, DCS, DCO are applied to the sickest patients and track with worse crude outcomes versus EDS, ETC, largely due to illness severity. Pediatric-specific indications and standardized outcome reporting are needed.
The Use of Artificial Intelligence in Emergency Case Transport, Diagnosis, and Treatment
Artificial intelligence (AI) is rapidly entering prehospital emergency care, where time-critical triage, transport, and early treatment decisions determine outcomes. We systematically reviewed original studies evaluating AI tools used before hospital arrival, focusing on prediction/triage, diagnostic support, and transport optimization, and synthesized insights from contemporary reviews to contextualize clinical adoption. Seven original studies met inclusion for quantitative results synthesis: an ensemble waveform-based triage model predicting lifesaving interventions in trauma; an AI-enhanced regional platform guiding hospital selection and first aid; two studies on prehospital ST-elevation myocardial infarction (STEMI) detection (mini-12-lead and smartphone capture); a randomized trial of AI dispatcher alerts for out-of-hospital cardiac arrest; a gradient-boosted model for dyspnea serious adverse events; and a deep-learning severity algorithm predicting need for critical care in EMS. Across studies, AI frequently achieved AUCs around or above 0.80, improved sensitivity or operational timeliness (faster ECG interpretation/feedback), and in specific subgroups reduced adverse outcomes (lower mortality when AI guided optimal hospital transfer). However, not all trials showed clinical recognition gains despite superior model sensitivity, underscoring implementation challenges. Current reviews emphasize the promise of AI alongside the need for rigorous prospective validation, workflow integration, transparency, and equity. AI can augment prehospital decision-making, but robust clinical pathways and governance remain essential.
Emergency department diagnosis and outcome of non-traumatic hypotension
This study aimed to determine the level of evidence on the diagnosis and prognosis of hypotensive nontraumatic patients in the prehospital and emergency department. The PRISMA statement was followed in the conduct of this study. Seven full-text articles were determined to be qualified and incorporated into the qualitative examination. We looked via electronic databases (PubMed, Google Scholar, and Cochrane) to find English-language publications published between 2006 and 2024. Seven papers total, four cohort studies, two cross-sectional studies, and one prospective exploratory research, were included in this systematic review. The included studies' durations varied from seven months to four years. Ultrasonography guided emergency diagnostic decisions in hypotension-presenting patients, and those decisions agreed well with the ultimate clinical diagnosis made after analyzing retrospective data. It was not possible to compare etiological characteristics in any of the seven qualifying investigations. By reducing the number of hypotensive states that may be accurately detected and facilitating the early discovery of potentially deadly diseases that can be treated rapidly, a lung examination performed as part of an ultrasonographic technique may expedite the diagnostic process.
Mapping Root and Canal Anatomy in Saudi Populations Using Cone-Beam Computed Tomography: Prevalence, Classification, and Clinical Implications for Endodontic Practice
Accurate understanding of root and canal anatomy is essential for endodontic success. Cone beam computed tomography (CBCT) improves visualization over 2 D imaging and supports systematic, reproducible interpretation in clinical practice. Objective: To synthesize CBCT based evidence on root and canal morphology in Saudi subpopulations and outline the clinical implications for access, scouting, and preparation. Methods: We followed PRISMA aligned methods to identify English original studies from Saudi centers reporting CBCT findings on permanent teeth. Eligibility included observational designs describing root number, Vertucci configuration, second mesiobuccal canal (MB2), C shaped canals, and relevant inter orifice measurements. Due to heterogeneity in tooth types, reporting schemes, and CBCT parameters, we conducted a structured narrative synthesis. Results: in included studies, mandibular molars most commonly exhibited two roots with three canals, with Vertucci type IV frequent in mesial roots and type I in distal roots. C shaped morphology was reported in mandibular molars, with notable regional and sex related variation. In maxillary molars, MB2 was detected in first molars and less often in second molars; inter-orifice spatial relationships were mapped at the pulp floor level, reinforcing the need for methodical troughing and magnification. Premolars were predominantly single-rooted/single-canal in mandibular arches, whereas maxillary first premolars commonly showed two roots; taxonomy influenced reporting. Conclusions: CBCT guided, tooth specific strategies integrating demographic risk cues, standardized interpretation, and meticulous clinical exploration, can reduce missed anatomy and optimize endodontic outcomes. Future multicenter studies using harmonized CBCT acquisition and classification frameworks are warranted to refine prevalence estimates and clinical pathways.
Copyright (c) 2025 Tazeez Public Health Journal