Prevalence of Pressure Injury on the Medical Wards of Public General Hospitals in Makkah

Background Pressure injury is a severe problem that can significantly impact a patient’s health, quality of life, and healthcare expenses. The prevalence of pressure injuries is a widely used clinical indicator of patient safety and quality of care. This study aims to address the research gap that exists on this topic in Makkah, Saudi Arabia by investigating the prevalence of pressure injuries and preventive measures on the medical wards of the country public general hospitals. Methods A cross-sectional research design was adopted to measure the point prevalence of pressure injuries on 30 medical wards in the public general hospitals. Data, including variables pertaining to hospitals, patients, pressure injuries and preventive practices, were collected using an online form. The data were processed and analysed using Microsoft Excel and SPSS 21 (α level = 0.05). Analysis provided an overview of patient, pressure injury characteristics and preventive measures, and the relationships between the patient and pressure injury characteristics and the prevalence of pressure injuries. A model for predicting the determinants of pressure injury prevalence was constructed from a linear regression analysis. Results The mean national prevalence of pressure injury was 17.6% (95% CI: 11.3–23.8). Purely community-acquired pressure injuries represent the majority of pressure injuries nationally (58.1%). Regarding preventive measures, “pressure injury assessment on admission” has been provided to 65.5% of patients. Correlation analysis revealed that the only statistically significant correlation with the prevalence of hospital-acquired pressure injury was “pressure injury assessment on admission”, which was strongly negative (ρ = −0.857). Therefore, this was the only variable included in the regression analysis as a predictor of pressure injury prevalence (Beta = 0.839). The results showed many statistically significant differences between hospitals with respect to the variables studied. Conclusions The national pressure injury prevalence is high compared to the global rate. The higher percentage of purely community-acquired pressure injuries requires particular attention. Many risk factors for the development of pressure injuries are public health concerns, and effective mitigating strategies are needed. Further research is required to assess the knowledge, attitude, and behavior of nurses with respect to pressure injuries, and to evaluate preventive and management practices

Nurses’ Adherence to Surgical Safety Guidelines for Patients Undergoing Abdominal Surgery

Background: Patient\u27s safety events at the operating room can be completely avoidable by adhering to surgical safety practices that aims to improve adherence to evidence-based safety practices, communication and team work during critical time points as during surgical procedure, before induction of anesthesia, before incision and before the patient leaves the room. Objective: This study aimed to assess nurses\u27 adherence to surgical safety guidelines for patients undergoing abdominal surgery. Subjects and methods: Design: A descriptive exploratory research design was used to achieve the aim of this study. Setting: This study was conducted at the Operating Departments affiliated to Makkah, Saudi Arabia. Study subjects: A convenient sample of all available nurses (75) from the previously mentioned departments was included in the study. Tools of data collection: Structured interview questionnaire included two parts: demographic characteristics of the studied nurses and surgical safety guidelines checklist. Result: This study presented that less than half of the studied scrub nurses and only minority of the circulating nurses and anesthesia nurses had competent practices at the operating room respectively. Conclusion: The study concluded there were statistically significant relations between competent practices of scrub nurses and their attendance of training courses related to surgical safety and between competent practices of circulating nurses, their age and years of experience, while, there were no statistically significant relations between competent practices of anesthesia nurses, their gender and attendance of training course. Recommendation: Ongoing staff development programs and continuing education are important for improving staff performance and maintaining patients\u27 safety

The Relationship between Vocabulary Size and Training in Vocabulary-Learning Strategies A Case Study of Preparatory Year Students at Saudi University

The present study investigates the relationship between vocabulary size and training in vocabulary-learning strategies (VLSs) among preparatory year students at a university in Saudi Arabia. Vocabulary size is important because there is a close association between the size of speakers’ vocabulary and the level of communication they can achieve (Nation, 2001). Sixty male students, twenty each from the humanities, science and health streams, participated in the study and ten students chosen randomly from each group participated in one one-hour long training session on VLSs each day for five consecutive days.The objectives of the study were (i) to discover VLSs that can be utilized by preparatory year students; (ii) to identify the English vocabulary size of the students, and (iii) to examine the effects of VLSs training on the results of vocabulary size tests taken by the students. Data were collected before and after the treatment using a VLSs Questionnaire adapted from Schmitt and McCarthy (1997), consisting of 50 Likert-scale items with a 0.78 reliability coefficient to explore the students’ use of VLSs before and after training. Secondly, XK-Lex (Masrai and Milton, 2012), a word recognition test, was used to measure the students’ vocabulary size before and after training. Thirdly, I used a research diary to record trainees’ expressions of their attitudes to VLSs at the end of each training session. The data were entered into the Statistical Package for Social Sciences (SPSS), version 25.The study found significant differences between the experimental and the control groups’ use of VLSs in the post-treatment, and the differences were positive in favour of the experimental group. When the experimental group was divided into fields of study, there was a statistically significant gain in the participants’ total vocabulary size after training in some fields, suggesting that the VLSs training had had a beneficial effect. The sample size in this field-specific analysis was, however, small and so the findings need to be treated with caution.</div

The impact of prehospital spinal immobilization in patients with penetrating spinal injuries:a systematic review and meta-analysis

Penetrating injuries, such as gunshot or stab wounds, may cause spinal cord injuries and require prehospital spinal immobilization (PHSI) to stabilize the spine. However, the use of PHSI in penetrating spinal injuries remains controversial. This systematic review aimed to investigate the efficacy of prehospital PHSI in patients with penetrating trauma. We systematically searched Google Scholar, Medline (PubMed), The Cochrane Central Register of Controlled Trials (CENTRAL), and EMBASE between January 2000 and July 2021. All studies in English that assessed PHSI in patients (&gt;16 years) with penetrating spinal injuries were included. Quality and risk of bias assessments were performed using the modified Newcastle-Ottawa scale. A narrative synthesis and a meta-analysis was conducted. Our search identified 928 studies but only 6 met our inclusion and exclusion criteria. All of the included studies were conducted in the US and the number of patients ranged from 156&ndash;75,567 over 3&ndash;9 study years. The majority of patients were gunshot or stab wounds. Three studies demonstrated an increased risk of mortality with spinal collars whilst the remaining three studies failed to show any benefits or the benefits remained unproven. All studies were retrospective studies with some risks of bias. This review highlights that the evidence from the literature on PHSI in penetrating trauma outweigh its benefits; thus, its use is discouraged in penetrating spinal trauma. However, further high-quality research is necessary to reach definitive conclusions and to possibly identify suitable alternatives to PHSI for penetrating spinal trauma

Clinical impacts of mammalian target of rapamycin expression in human colorectal cancers

This study investigated the clinicopathologic roles of mammalian target of rapamycin (mTOR) expression and its relationship to carcinogenesis and tumor progression in a colorectal adenoma-adenocarcinoma model. Two colon cancer cell lines with different pathologic stages (SW480 and SW48) and 1 normal colonic epithelial cell line (FHC) were used, in addition to 119 colorectal adenocarcinomas and 32 adenomas. mTOR expression profiles at messenger RNA (mRNA) and protein levels were investigated in the cells and tissues using real-time quantification polymerase chain reaction and immunohistochemistry. The findings were correlated with the clinicopathologic features of the tumors. The colon cell line from stage III cancer (SW48) showed higher expression of mTOR mRNA than that from stage II cancer (SW480). At the tissue level, mTOR showed higher mRNA and protein expression in colorectal carcinoma than in adenoma. The mRNA and protein expression was correlated with each other in approximately one-third of the carcinomas and adenomas. High levels of mTOR mRNA expression were noted more in carcinoma or adenoma arising from the distal portion of the large intestine (P = .025 and .019, respectively). Within the colorectal cancer population, a high level of expression of mTOR mRNA was related to the presence of lymph node metastases (P = .031), advanced pathologic stage (P = .05), and presence of persistent disease or tumor recurrence (P = .035). To conclude, the study has indicated that mTOR is likely to be involved in the development and progression of colorectal cancer and is linked to cancer initiation, invasiveness, and progression

Chemical Inhibitors and microRNAs (miRNA) Targeting the Mammalian Target of Rapamycin (mTOR) Pathway: Potential for Novel Anticancer Therapeutics

Abstract: The mammalian target of rapamycin (mTOR) is a critical regulator of many fundamental features in response to upstream cellular signals, such as growth factors, energy, stress and nutrients, controlling cell growth, proliferation and metabolism through two complexes, mTORC1 and mTORC2. Dysregulation of mTOR signalling often occurs in a variety of human malignant diseases making it a crucial and validated target in the treatment of cancer. Tumour cells have shown high susceptibility to mTOR inhibitors. Rapamycin and its derivatives (rapalogs) have been tested in clinical trials in several tumour types and found to be effective as anticancer agents in patients with advanced cancers. To block mTOR function, they form a complex with FKBP12 and then bind the FRB domain of mTOR. Furthermore, a new generation of mTOR inhibitors targeting ATP-binding in the catalytic site of mTOR showed potent and more selective inhibition. More recently, microRNAs (miRNA) have emerged as modulators of biological pathways that are essential in cancer initiation, development and progression. Evidence collected to date shows that miRNAs may function as tumour suppressors or oncogenes in several human neoplasms. The mTOR pathway is a promising target by miRNAs for anticance

The diagnostic accuracy of prehospital triage tools in identifying patients with traumatic brain injury: A systematic review

Introduction Prehospital care providers are usually the first responders for patients with traumatic brain injury (TBI). Early identification of patients with TBI enables them to receive trauma centre care, which improves outcomes. Two recent systematic reviews concluded that prehospital triage tools for undifferentiated major trauma have low accuracy. However, neither review focused specifically on patients with suspected TBI. Therefore, we aimed to systematically review the existing evidence on the diagnostic performance of prehospital triage tools for patients with suspected TBI. Methods A comprehensive search of the current literature was conducted using Medline, EMBASE, CINAHL Plus and the Cochrane library (inception to 1st June 2021). We also searched Google Scholar, OpenGrey, pre-prints (MedRxiv) and dissertation databases. We included all studies published in English language evaluating the accuracy of prehospital triage tools for TBI. We assessed methodological quality and risk of bias using a modified Quality Assessment of Diagnostic Studies (QUADAS-2) tool. Two reviewers independently performed searches, screened titles and abstracts and undertook methodological quality assessments. Due to the heterogeneity in the population of interest and prehospital triage tools used, a narrative synthesis was undertaken. Results The initial search identified 1787 articles, of which 8 unique eligible studies met the inclusion criteria (5 retrospective, 2 prospective, 1 mixed). Overall, sensitivity of triage tools studied ranged from 19.8% to 87.9% for TBI identification. Specificity ranged from 41.4% to 94.4%. Two decision tools have been validated more than once: HITS-NS (2 studies, sensitivity 28.3–32.6%, specificity 89.1–94.4%) and the Field Triage Decision Scheme (4 studies, sensitivity 19.8–64.5%, specificity 77.4%-93.1%). Existing tools appear to systematically under-triage older patients. Conclusion Further efforts are needed to improve and optimise prehospital triage tools. Consideration of additional predictors (e.g., biomarkers, clinical decision aids and paramedic judgement) may be required to improve diagnostic accuracy