REVIEW ARTICLE | Dec. 30, 2024
Optimizing the Technologist's Role in the "Golden Hour" of Trauma Care: A Narrative Review
Faridah Ahmed Mohammad Baraqaan, Raed Mesfer Alzahrani, Mashraf Salam Alrawili, Abdulrahim Hassan Almalki, Ahmed Sanhat Alharbi, Yasir lnad Dhaher Alanazi, Almd Muteb O Alblawi, Mohammed Faleh M Albalawi, Ebrahem Salem Suleman Al Hassani, Mohammed Saad F Alrefaie, Thamer Marzouq AlBalawi, Abdullah Mohammed Almehmadi, Hatim Maqpoul Alkhaldi, Nawaf Yahya Aljohani, Hassan Mabrok Ali Alnahdi
Page no 1011-1020 |
DOI: https://doi.org/10.36348/sjmps.2024.v10i12.021
This narrative review synthesizes the existing literature to define and optimize the distinct and coordinated roles of allied health technologists during the critical initial phase of trauma care. The analysis is framed within the modern interpretation of the "Golden Hour" not as a literal 60-minute timeframe, but as a guiding principle of urgency that demands rapid, parallel, and protocol-driven actions to save life and limb. Through a narrative review of peer-reviewed literature, clinical guidelines, and professional standards focusing on adult trauma care in Level I and II trauma centers, this paper examines the contributions of a spectrum of specialists: Emergency Medical Technicians (EMTs), Medical Laboratory Technicians, Radiology Technologists, Anesthesia Technologists, Pharmacy Technicians, and Dental Assistants. The key finding of this review is the identification of a complex system of interdependent, time-sensitive tasks performed by these technologists, which collectively form the diagnostic and preparatory foundation for all definitive surgical and medical interventions. A central theme emerges wherein the efficiency and success of the entire trauma response are contingent on the seamless communication and coordination between these technologist specialties. The review concludes that the "Golden Hour" is saved not only by the visible leadership of physicians and nurses but by the rapid, highly coordinated, and often unseen efforts of this multidisciplinary technologist team. Consequently, this paper advocates for greater institutional recognition of these essential roles, the development of integrated, technologist-inclusive trauma protocols, and the mandatory inclusion of all relevant technologist specialties in high-fidelity interdisciplinary trauma simulations to enhance system-wide performance and improve patient outcomes.
REVIEW ARTICLE | Dec. 30, 2024
A Multidisciplinary Framework for the Prevention of Contrast-Induced Nephropathy: Synergies in Different Specialties
Tariq Saleh Shahwan Alzahrani, Sharaf Mubarak Ahmed Alzahrani, Sultan Saad Mannaa Alamri, Ahmed Abdulrhman Alasmari, Abdullah Saeed Shukri Alshehri, Sulaiman Rames Alshehri, Turki Ahmed Alzhrani, Adel Saeed Asseri, Mastour Awwadh Alharthi, Abdulaziz Ali Al amri, Ibrahim Mohammed Ghajri, Amer Ramzi Albarqi, Abdulkarim Antar Q Al Otaibi, Modhi Khalid AlHariqi
Page no 1021-1032 |
DOI: https://doi.org/10.36348/sjmps.2024.v10i12.022
The administration of iodinated contrast media (ICM) is indispensable for modern diagnostic and interventional procedures. However, the subsequent development of acute kidney injury (AKI) represents a significant clinical challenge, associated with increased morbidity, mortality, and healthcare expenditure. Historically termed contrast-induced nephropathy (CIN), the understanding of this condition has evolved, leading to the more precise term contrast-associated AKI (CA-AKI) to reflect a temporal association rather than assumed causality. The pathophysiology is multifactorial, involving direct tubular cytotoxicity, renal vasoconstriction leading to medullary hypoxia, and oxidative stress. While the risk is low in the general population, it is markedly elevated in patients with pre-existing chronic kidney disease (CKD), diabetes mellitus, heart failure, and in the context of intra-arterial procedures with high contrast volumes. The prevention of CA-AKI has traditionally been managed in departmental silos, an approach that is often fragmented and unreliable. This review proposes a comprehensive, multidisciplinary framework that integrates the expertise of four key pillars: Radiology, Pharmacy, Anesthesia, and Public Health. Effective prevention begins with a shared foundation of robust risk stratification, leveraging quantitative scoring systems and automated electronic health record (EHR) alerts. The Pharmacy pillar focuses on evidence-based pharmacological and medication management, including standardized hydration protocols, controversial adjunctive therapies like N-acetylcysteine and statins, and a critical "nephrotoxic hold" on high-risk medications. The Radiology pillar centers on procedural optimization through the selection of appropriate contrast agents, strict adherence to the principle of dose minimization guided by dose-to-eGFR ratios, and the use of advanced technologies like automated injectors and ultra-low contrast techniques. The Anesthesia pillar provides intraprocedural hemodynamic stewardship for high-risk patients, maintaining renal perfusion through goal-directed fluid therapy and judicious use of vasopressors. Finally, the Public Health pillar provides the system-level architecture for success, designing and implementing hospital-wide "prevention bundles," fostering interdepartmental communication, promoting patient education, and driving continuous quality improvement through audit and feedback. By synergizing these distinct but complementary roles, healthcare systems can transition from a reactive to a proactive and reliable model of care, significantly reducing the clinical and economic burden of CA-AKI.
Background: Children's headaches are not well understood, and diagnosis can be difficult. Children who get frequent headaches are frequently badly impacted. The relationship between lifestyle factors including food, exercise, and sleep and the occurrence of headaches, particularly migraines, has been investigated mostly in adults, leading to changes in lifestyle as a conventional treatment in addition to medical therapy. Objective: To find out clinical profile of children with recurrent headache. Materials and Methods: This is a cross sectional study was conducted Centre for Neurodevelopment and Autism in Children (Pediatric Neurology OPD), Dept. of Pediatrics of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka during January 2022 to June 2022. Total of 100 children attending with recurrent headache were taken consecutively over a period of six months for this study. Patient with recurrent headache were classified (diagnosed) based on clinical presentation (according to International Headache Society diagnostic criteria). Results: The majority of patients (54%) suffered migraines without aura, and 48% had severe headaches. 70% of patients exhibited sensitivity to bright light during a headache episode, 80% had sensitivity to noise, 85% had no headaches while playing TV video games, and 66% had a history of headaches caused by sun exposure. Conclusion: Males dominated in the pre-pubertal age range, whereas girls dominated after puberty. The most prevalent RHA diagnosis was migraine without an aura. Headache triggers or precipitating factors were also compared to previous research.
ORIGINAL RESEARCH ARTICLE | Dec. 30, 2024
Comparison of Visual Outcome and Optical Quality Monofocal vs Monofocal Plus Intraocular Lens
Prof. Dr. Md. Sanwar Hossain, Dr. Tasnim Khanom, Dr. Md. Arifuzzaman, Dr. Mohammad Mazaharul Islam
Page no 990-994 |
DOI: https://doi.org/10.36348/sjmps.2024.v10i12.017
Background: Traditional mono-focal intraocular lenses (IOLs) have been commonly used in cataract surgery but have limited intermediate vision. These lenses are designed to achieve improved visual outcomes and optical quality without the drawbacks associated with multifocal lenses. The present study compares visual outcomes, optical quality, and patient satisfaction for Monofocal versus Monofocal-Plus IOLs. Methods: This postoperative observational study was carried out at Department of Ophthalmology, Dr. Sirajul Islam Medical College and Hospital and Bangladesh Eye Hospital, Dhaka, Bangladesh, from July 2022 to June 2023, including 40 cataract surgery patients. Patients were divided in Monofocal IOL (n=20) & Monofocal-Plus IOL (n=20) groups. Preoperative 1-month and 3-month follow-up assessments of visual acuity (LogMAR), contrast sensitivity (logCS), higher-order aberrations (HOA), and patient satisfaction scores were performed. SPSS version 26 was used to analyze data, with a p<0.05 significance level. Results: Uncorrected visual acuity was significantly better 3 months post-op with mono-focal-plus IOL at 3 months (p=0.008), photopic contrast sensitivity (p=0.04), and spherical aberration (p=0.00). There was a trend toward improvement in best-corrected visual acuity (p=0.08). Monofocal-Plus IOL patients reported significantly lower glare (p=0.01) and halos (p=0.01) and better night vision quality scores (p=0.005). The requirement for more spectacles was less in the Monofocal-Plus group (15.0% vs. 35.5%), but not significant (p=0.14). Conclusion: Compared to Monofocal IOLs, Monofocal-Plus IOLs provide better visual performance, optical quality, and higher patient satisfaction. These findings support their adoption as an IOL of choice in cataract surgery.
ORIGINAL RESEARCH ARTICLE | Dec. 30, 2024
Crude Oil Exploration Activities and Particulate Matter Pollutants Concentration in Selected Rivers East and Rivers South-East Senatorial Communities, Rivers State
Okwakpam, I. O, Onugha, A. C
Page no 440-449 |
DOI: https://doi.org/10.36348/sjhss.2024.v09i12.006
The study examined crude oil exploration activities and particulate matter pollutants concentration in selected Rivers East and Rivers South-East communities, Rivers State. The study adopted the completely randomized block design (CRBD). Ambient air quality readings were taken in-situ in four (4) stations (two each from each of the communities) using the Aero Qual 500 Series (Gas Monitor), GT 321 Particulate Metre, Automated Global Position System (GPS), and Extech Meteorology Metre, While mean and clustered column chart was used to analyze the data. The study revealed the concentrations of 694 ppm and 613 ppm for CO2 in Bodo and Igwuruta communities respectively which were higher than the WHO daily approved limit of 462 ppm. The study further revealed that the higher concentration of particulate matter pollutants (PMPs) like (NO2 = 0.098 μg/m3, O3 = 0.04 μg/m3, So2 = 0.00 μg/m3, H2S = 0.01 μg/m3, CH4 =0 μg/m3, CO = 0.5 μg/m3, NH3 =0.3 μg/m3, Pm 2.5 = 0.022 μg/m3, Pm 10 = 0.018 μg/m3, temperature = 34.6 oC) obtained at the Bodo artisanal refining sites and that obtained at the Igwuruts flow station were all still within the WHO daily approved limits for the specific PMPs. Also, the excessive concentration of CO2 accentuates the presence of soot that exacerbates the discolouration of vegetation as well as poor air quality, residents’ high susceptibility to skin diseases, cancer and respiratory ailments, intense heat, respiratory complications like cough, carthar, etc. The study recommended amongst others that more trees should be planted to absorb the excess CO2 that accentuates the buildup of soot that damage the built environment; destroy car windshield, roof surfaces, house floors and windows and also, causing health risk of rashes, aging, asthma, bronchitis on the residents around the environs of the Agbada/Igwuruta flow station and Bodo artisanal refining site.
REVIEW ARTICLE | Dec. 30, 2024
Role of Molecular Biomarkers in Non-Small Cell Lung Carcinoma in Diagnosis and Treatment Prediction
Rami Abdullah Ali Al Daghreer, Hamad Aldaghreer, Smita Sharma
Page no 563-567 |
DOI: https://doi.org/10.36348/sjm.2024.v09i12.009
Lung cancer is leading cause of mortality worldwide. About 80-85% of lung cancers are nonsmall cell lung carcinomas (NSCLC). The main subtypes of NSCLC are adenocarcinoma, squamous cell carcinoma and large cell carcinomas. These NSCLC are grouped together as their treatment and prognosis is often similar. Diagnosis depends on symptoms, histopathology and molecular biomarkers. Even treatment in late stages of NSCLC requires appropriate testing with predictive molecular biomarkers as it provides information that is essential for establishing appropriate treatment options for each patient. This review paper provides current molecular biomarkers in NSCLC which are useful in diagnosing as well predicting treatment.
REVIEW ARTICLE | Dec. 30, 2024
Effect of Teamwork of Different Departments of Health Facilities in Refining and Enhancing the Healthcare Conveyance
Mohammed I. Alshammari, Bander A. Albedaiwi, Talal A. Alotaibi, Mohammed D. Alshammari, Majeeda S. Alqurashi, Khalid N. Alomar, Faisal O. Albulushi, Salman B. Alanazi, Faiz T. D. Alharbi, Rami D. S. A. mutraffi, Abdullah I. Almajdi, Obaid O. A. Mutairi, Abdullah M. A. Alsuayri, Talal S. Alsuwat, Feras S. Aljizani
Page no 1006-1010 |
DOI: https://doi.org/10.36348/sjmps.2024.v10i12.020
Healthcare technicians play a pivotal role in the modern healthcare system, serving as the backbone of various medical disciplines. This review article explores the multifaceted roles of healthcare technicians across five key areas: radiology, nursing, laboratory services, medical records, and pharmacy. Each section delves into the specific responsibilities, skills, and contributions of technicians in these fields, highlighting their importance in enhancing patient care, ensuring safety, and improving healthcare outcomes. By examining the evolving landscape of healthcare technology and the increasing complexity of patient needs, this article underscores the necessity for ongoing education and collaboration among healthcare technicians and other professionals. Ultimately, the integration of healthcare technicians into multidisciplinary teams is essential for delivering comprehensive and effective patient care.
REVIEW ARTICLE | Dec. 30, 2024
Systematic Review about Chronic Obstructive Pulmonary Diseases in Saudi Arabia
Mohammed Ali Alshahrani, Mosa Theeban Al Garni, Yousef Ali Alzamil, Khaled Jobran Alshahrani, Mohammed Saad Alahmari, Abdullah Ahmed Albeair, Mohammed Abdullah Alamri, Eyad Hassan Jaber Alkadi, Mohammed Moshabbab Alahmari
Page no 995-1000 |
DOI: https://doi.org/10.36348/sjmps.2024.v10i12.018
Background: Chronic obstructive pulmonary disease is one of the most common non-communicable illnesses, having the potential to be fatal, it is now the third leading cause of death worldwide. Objectives: The aim of our study was to estimate the prevalence of COPD, its associated risk factors, causes and management in Saudi Arabia. Methods: For article selection, the PubMed database and EBSCO Information Services were used. All relevant articles relevant with our topic and other articles were used in our review. Other articles that were not related to this field were excluded. The data was extracted in a specific format that was reviewed by the group members. Conclusion: In Saudi Arabia, the prevalence estimated of COPD is relatively high, moreover it increases by time. High prevalence of smoking and increased age was reported to be the most common effective risk factors of COPD in Saudi population. COPD is now considered a preventable and potentially treatable disease if detected in the early stages. Avoidance of exposure to harmful particles, mainly smoking, can prevent progression to a clinically significant stage of the disease.
SUBJECT CATEGORY: HEALTH MANAGEMENT | Dec. 29, 2024
The Role of Artificial Intelligence in Financial Risk Management: Enhancing Investment Decision-Making in Mergers and Acquisitions
Kelechi Agubata, Yusuf Oluwatobiloba Ibrahim
Page no 275-279 |
DOI: https://doi.org/10.36348/sb.2024.v10i10.004
This research examines Artificial Intelligence (AI) and Machine Learning (ML) applications in financial risk assessment and investment strategies for mergers and acquisitions (M&A). A comprehensive analysis of over 20,000 global deals from 2013-2023 shows that integrating Ai to predict M&As could reduce transaction failure rates and increase valuation accuracy. After testing multiple algorithms, the XGBoost classifier performed best for merger success with a recall of 60% and precision of 62% on historical data from the Institute of Mergers, Acquisitions and Alliances. The main contribution of this work is a new integrated framework that combines AI-driven quantitative analysis with human expert judgment, addressing the fundamental limitations of both purely algorithmic and solely human-driven approaches to M&A evaluation. This outperforms existing benchmarks in the literature and is a big step forward in predictability. The results also suggest explainable AI architectures, human-machine collaboration protocols and multidisciplinary training for professionals to ensure accountability, transparency and operational efficiency. The research concludes that AI in M&A is not just about the technology but about how it’s integrated with human judgment, ethical governance and context specific communication frameworks
CASE REPORT | Dec. 28, 2024
Molar Intrusion in the Management of Anterior Openbite and ‘High Angle’ Class II Malocclusions: About a Case Report
Nadia Madhi, Yesmine Abid, Wiem Ben Amor, Ines Dallel, Samir Tobji, Adel Ben Amor
Page no 338-344 |
DOI: https://doi.org/10.36348/sjodr.2024.v09i12.004
Anterior open bite is a complex malocclusion that often requires comprehensive treatment due to its multifactorial etiology and high relapse potential. Conventional treatment options such as orthognathic surgery or extraction therapy may have limitations. Recent advancements in skeletal anchorage have introduced miniscrews as a minimally invasive and reliable alternative. This case report illustrates an 18-year-old female with sagittal skeletal Class II pattern, hyperdivergent facial type and class I molar and end-on Class II canine relationship, with an anterior open bite. The treatment plan consisted of using miniscrews placed bilaterally in the posterior maxilla to facilitate molar intrusion. A transpalatal arch was used to maintain transverse stability during the intrusion phase. The approach resulted in effective molar intrusion, closure of the open bite, and an improved facial profile.
CASE REPORT | Dec. 28, 2024
Orthodontic Management of Deep Bite with Aligners: A Case Report and Review of the Literature
Ala Hajjem, Mahmoud Qalalwa, Fatma Abdelkader, Wiem Ben Amor, Ines Dallel, Samir Tobji, Adel Ben Amor
Page no 331-337 |
DOI: https://doi.org/10.36348/sjodr.2024.v09i12.003
The primary motivation for individuals with deep-bite malocclusion seeking orthodontic treatment is the improvement of aesthetics, occlusion, and functions. Deep bites can be treated by the intrusion of anterior teeth and the extrusion of the posterior teeth, or both, according to the exposure of the incisors in the smile. In this case report, we present the treatment of a female patient with a deep-bite malocclusion. This paper describes the clinical and radiographic changes with orthodontic treatment using Invisalign clear aligners and their effectiveness to normalize the overjet and overbite and enhance both aesthetics and functions.
SUBJECT CATEGORY: MATHEMATICS | Dec. 28, 2024
Killing Motion of Static Cylindrically Symmetric Spacetimes in the f(R) Gravity
Fakhar Alam, Muhammad Shoaib, Sajid Ali, Saeed Ahmad, Muhammad Idrees, Sofia Batool, Syed Wajahat Ali Bukhari
Page no 267-274 |
DOI: https://doi.org/10.36348/sb.2024.v10i10.003
In this study we have studied "Killing Motion of Static Cylindrically Symmetric Spacetimes in f(R) Gravity" by using algebraic and direct integration techniques. This study investigates the Killing motions of static cylindrically symmetric spacetimes with in framework of f(R) gravity, a generalization of Einstein’s General Relativity. We explore the existence of Killing vector fields to understand the symmetries and conserved quantities in such spacetimes. By analysing the modified field equations, we determine the constraints imposed by f(R) gravity on the geometry and dynamics of cylindrically symmetric spacetimes. These contribute to understanding the interplay between symmetry properties and gravitational theories beyond General Relativity. The results have implications for astrophysical and cosmological models influenced by alternative gravity theories. We discussed four cases and found that the dimension of Killing vector fields is either three, four or ten.
Snakebites are serious public health problem in many regions of the world, particularly in rural areas lacking medical facilities. Snake bite is a well-known occupational hazard amongst farmers, plantation workers, and other outdoor workers and results in much morbidity and mortality throughout the world. This occupational hazard is no more an issue restricted to a particular part of the world; it has become a global issue. Accurate statistics of the incidence of snakebite and its morbidity and mortality throughout the world is difficult to publish, however, it is certain to be higher than what is reported. This is because even today most of the victims initially approach traditional healers for treatment and many are not even registered in the hospital. Hence, registering such patients is an important goal if we have accurate statistics and reduce the morbidity and mortality due to snakebite. World Health Organization (WHO) has published guidelines for the clinical management of snakebites. In this article the author tries to throw light on the incidence and clinical features of snakebite and the management and treatment guidelines as per the WHO recommendation.
ORIGINAL RESEARCH ARTICLE | Dec. 28, 2024
Skeletal Class II with Open-Bite Malocclusion Treated with Orthodontics and Orthognathic Surgery
Ala Hajjem, Yesmine Abid, Hamza Gaaloul, Wiem Ben Amor, Ines Dallel, Samir Tobji, Adel Ben Amor
Page no 324-330 |
DOI: https://doi.org/10.36348/sjodr.2024.v09i12.002
Enhancing aesthetics, occlusion and functions is a primary motivation for individuals with open-bite malocclusion seeking orthodontic treatment. Open-bite malocclusion, characterized by a lack of vertical overlap of the anterior teeth, can be effectively treated with a combined surgical and orthodontic approach. In this case report, we present the treatment of a male patient with an open-bite malocclusion and a skeletal class II. Initially, the patient underwent a presurgical phase where fixed orthodontic appliance was bonded to achieve well-aligned arches, then came the maxillary impaction to normalize the overjet and overbite and enhance both aesthetics and functions. Keywords: Skeletal Class II, Open-Bite Malocclusion, Orthodontic Treatment, orthognathic surgery, Maxillary Impaction.
ORIGINAL RESEARCH ARTICLE | Dec. 27, 2024
Impact of Urinary Tract Infection (UTI) on Maternal and Fetal Outcomes During Pregnancy; A Tertiary Care Hospital Experience
Zebun Nessa Begum, Md. Ghulam Yusuf, Anisa Begum
Page no 665-670 |
DOI: https://doi.org/10.36348/sijog.2024.v07i12.012
Background: Urinary tract infection (UTI) is one of the most prevalent bacterial infections during pregnancy, associated with significant maternal and fetal morbidity if left untreated. The physiological changes of pregnancy, such as urinary stasis and altered urine composition, increase the risk of both symptomatic and asymptomatic UTIs. Early identification and management are therefore crucial. Aim of the study: To evaluate the incidence of urinary tract infections during pregnancy and assess the associated maternal and fetal outcomes in a tertiary care setting. Methods: This prospective study was conducted over two years in the Department of obstetrics and Gynecology, Rangpur Community Medical College Hospital, Rangpur, Bangladesh. A total of 220 pregnant women aged 18–40 years were enrolled, of whom 41 were diagnosed with UTI based on clinical presentation, urine microscopy, and culture sensitivity. Patients were classified as having symptomatic or asymptomatic UTI and were followed throughout pregnancy and postpartum for adverse outcomes. Statistical analysis was performed using SPSS version 26. Result: Among the 41 UTI-positive cases, the highest incidence (60.98%) was observed in women aged 18–25 years and in primigravida patients (56.10%). The majority (58.54%) of infections occurred during the second trimester. Asymptomatic UTI accounted for 65.25% of cases. The most common pathogen was Escherichia coli (36.59%), followed by Klebsiella (24.39%). Adverse maternal outcomes included anemia (26.83%), puerperal pyrexia (24.39%), and abortion (12.20%). Fetal complications included preterm birth (36.59%), fetal growth restriction (14.63%), and perinatal mortality (12.20%). Conclusion: UTI during pregnancy is a frequent and often silent infection, with significant implications for both maternal and fetal health. Routine screening and prompt treatment are essential, especially during the second trimester, to minimize complications such as preterm labor, intrauterine growth restriction, and perinatal mortality.