Improving Medical Emergency Team Response Time for Urgent Care Patients in Primary Health Care Centers, Riyadh, Saudi Arabia

Background: Emergency healthcare systems are of increasing concern in international healthcare developments and the global fight against the burdens of disease. Concerns about focusing on ambulance response time as a single indicator are addressed by showing a case-sensitive approach for developing emergency health care systems that in return can identify ambulance response as the main indicator for a particular system. Problem description: Data collected by monitoring the time of receiving the call at the ambulance division until transport time.Methods: The fishbone diagram is used as a tool for understanding the process variation, investigate and eliminating unusual occurrences by the following methodology: M.M.M.Main outcomes: Responding time in emergency cases not exceeding 5 minutes; To improve responding time; To improve types of communication; To improve compliance with the logbook of the emergency referred cases. The intervention plan was Continuous Training for the staff and Clear Guidelines for emergency calls. Review and assess the actual implementation of the project. Data will be collected by an Emergency Medical specialist. A copy of the data should be sent to CQI for a continuous monitoring process. Check the data for process improvement (incident report analysis). Document the results of the change. Modify the change, if necessary and possible. The Emergency Medical Technicians quality coordinator will check the Data. Continue improvement by close monitoring of the compliance.Results: the mean response time dropped from 15 minutes in January 2023 to less than 5 minutes in December 2023.Conclusion: this initiative positively impacts the emergency team's response time and improves patient satisfaction. Response time reduction was evident, and the quality of the health care service was improved. Reduction of response time also improved emergency preparednes

The efficacy of topical treatments for acanthosis nigricans: a systematic review of randomized controlled trials

BackgroundAcanthosis nigricans (AN) is a skin disorder marked by darkening and thickening of the skin, often linked to metabolic abnormalities. This systematic review of randomized controlled trials (RCTs) assesses the comparative effectiveness and tolerability of different topical treatment options of AN, aiming to determine the most suitable therapeutic strategies.MethodsA comprehensive literature search was conducted across PubMed, Scopus, ClinicalTrials.gov, Web of Science, and the Cochrane Library, yielding 6,407 studies. After screening and a full-text review, seven randomized controlled trials (n = 268) assessed topical urea (10–20%), tretinoin (0.025–0.05%), salicylic acid (10%), and chemical peels such as glycolic acid (35–70%) and trichloroacetic acid (15%) over 8 weeks to 2 months, primarily on the neck and axilla. Outcomes included melanin and erythema indices (M/E), ANASI/ANSC scores, Investigator’s and Participant’s Global Evaluation (IGE/PGE), and adverse events.ResultsUrea demonstrated significant efficacy in reducing erythema, particularly at higher concentrations (20%), with mild adverse events such as stinging or irritation. Tretinoin was the most effective for reducing dark pigmentation, especially on the neck, and patients were more satisfied with it than with glycolic acid. Salicylic acid (10%) gave results similar to urea, with only mild side effects like dryness or peeling. Trichloroacetic acid (15%) peel was more effective than glycolic acid (35%) peel, both in skin improvement and patient satisfaction after 8 weeks. Overall, side effects with all treatments were mild and went away on their own.ConclusionBoth urea and tretinoin are effective treatments for AN, choice of therapy should be individualized tretinoin for predominant hyperpigmentation, urea for erythema or lower irritation tolerance, salicylic acid as a tolerable alternative, and TCA peel when stronger procedural options are suitable glycolic peel showed more modest effects.Systematic review registrationProspero registration number: (CRD42023444441); https://www.crd.york.ac.uk/PROSPERO/view/CRD42023444441

Efficacy and safety of topical minocycline preparations for papulopustular rosacea: a systematic review and meta-analysis

BackgroundRosacea is a chronic inflammatory skin condition. Papulopustular rosacea (PPR), one of the subtypes of rosacea, presents with papules and pustules (Pelle, 2008). Topical minocycline allow the delivery of high concentrations of the medication to the skin while decreasing systemic exposure thereby evading side effects (Jones et al., 2021, Webster et al., 2020). This study aims to review the literature to delineate the efficacy and safety of topical preparations of minocycline in the treatment of moderate to severe papulopustular rosacea.MethodsThis systematic review included randomized clinical trials (RCT) only that compared the efficacy and safety of 1.5% minocycline foam and 1%, 3% minocycline gel versus placebo in patients with moderate to severe papulopustular rosacea. We performed a systematic search in Medline, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, and ClinicalTrials.gov. Efficacy outcomes included the absolute change in inflammatory lesion counts, the percentage change in the inflammatory lesion count, the percentage of participants achieving Investigator Global Assessment (IGA) with improvement of at least two grades, and the proportion of individuals that achieved an IGA 0/1 score (“clear” or “almost clear”). This paper was conducted in adherence to PRISMA guidelines. Also, we have registered our protocol in PROSPERO (CRD42023447486). Quality assessment of the included studies was conducted using ROB-2 tool. Additionally, we have assessed the level of evidence using GRADE too. The analysis was performed using RevMan.ResultsFive randomized controlled trials with low risk of bias were included in the quantitative synthesis with a total of 2,453 enrolled participants. Minocycline (FMX103) 1.5% foam yielded statistically significant results in terms of IGA score indicating treatment success [Risk Ratio (RR) = 1.31, 95% confidence interval (CI) = 1.04–1.66, P = 0.02]. FMX103 and minocycline gel 1% and 3% had significant results in absolute change in inflammatory lesion count (RR = 3.49, 95% CI = 2.61–4.36, P < 0.00001). Change in inflammatory lesion count from baseline with minocycline 1.5% foam was significantly reduced (RR = 9.45, 95% CI = 5.84–13.06, P < 0.00001). Other indicators of symptom reduction were not significant for both foam and gel preparations.ConclusionOur findings suggest that topical preparations of minocycline provide statistically significant results in reducing absolute inflammatory lesion count and having IGA treatment success among patients with moderate to severe papulopustular rosacea. Further studies, however, should assess the efficacy of different concentrations and combinations of minocycline to better delineate the effect of this drug in the clinical aspect.Systematic review registrationPROSPERO, identifier CRD42023447486, https://www.crd.york.ac.uk/PROSPERO/view/CRD42023447486

The impact of childhood atopic dermatitis on quality of life of the paediatric population

BackgroundAtopic Dermatitis (AD) is a chronic skin condition characterized by pruritis which presents with xerosis, lichenification, and the eruption of eczematous lesions.AimsTo measure the quality of life in the paediatric population with atopic dermatitis at King Abdulaziz Medical City in Jeddah, Saudi Arabia.Methods The assessment tool utilized was the Infants' Dermatitis Quality of Life Index (IDQOL) questionnaire which is validated and available in Arabic. The sample size is 80 participants. Demographics, history of atopy, current treatment, and the percentage of body involved were described as frequencies. Chi-square test was performed to determine if there was a significant difference between gender, age group and the presence of other atopic disease in comparison to percentages of body involved. The analysis of the questionnaire’s items was done by One-way ANOVA to determine where significant impact on quality of life was present.Results There was a significant difference in overall IDQOL score between patient who had asthma with AD and those who did not (p=0.016). Significantly, the higher the percentage of body area affected by AD, the higher IDQOL score (p < 0.0001). No significant difference was identified for the chi-square test. Among questionnaire’s items sleep disturbance was affected the most among patients in relation to increase in distribution of disease along the body (p < 0.0001).ConclusionThe study concluded that the IDQoL among paediatric population with Atopic Dermatitis was significantly impaired, and it showed that the disease severity was proportionally related to the impairment of patients’ quality of life. Therefore, we highly recommend further studies in the same field to be able to generalize the results in the Saudi paediatric population

Clinical Laboratory Test And Radiological Methods In Diagnosis Of Orthopedics Condition: Role Of Nurses In Facilitating These Procedures: Review

Despite the fact that the fields of radiological imaging, pathology, and laboratory analysis appear to be very different from one another, the medical diagnostic information that these sources provide has a great deal in common with one another. This information can be utilized effectively by encouraging the sharing of quantitative and qualitative results through the utilization of modern information technology processes. Developing the capacities of informatics to coordinate the analysis of pictures produced by clinical radiological imaging, anatomic cellular and molecular pathology, and data gained from the analysis of biomarkers in the laboratory; this method is based on the development of these capabilities. This skill helps to stimulate the formation of novel "integrated diagnostics" in orthopedic disorders, and nursing plays an important part in the technical aspects of many orthopedic operations

The Important Role of Optometrist and Qualified Nursing in Primary Healthcare for Eye Care

The use of evidence-based practice is essential for delivering high-quality care, ensuring patient satisfaction, and making efficient use of limited healthcare resources. Nevertheless, there have been reports of inconsistency in the administration of evidence-based eye care. To enhance our comprehension of the obstacles and enablers to delivering optometric care, it is necessary to recognize the significant role that optometrists play in providing primary eye care. This narrative study sought to identify the provision of eye care services by optometrists and measures that could enhance the delivery of eye care in primary care settings, alongside certified nursing. In the field of optometry, similar to other healthcare professions like nursing, there has been a broadening of the optometrist\u27s responsibilities in primary eye care. This includes taking on tasks such as prescription medication, which was previously done by general practitioners. Within the field of optometry, this expanded responsibility entails overseeing eye diseases that do not necessitate treatment or monitoring in secondary healthcare settings, which were historically referred to. Nevertheless, any expanded responsibility necessitates educational assistance

Focal dermal hypoplasia: Unusual presentation in Saudi Arabia

AbstractFocal dermal hypoplasia (Goltz syndrome) is a rare genetic multisystem characterized by multiple abnormalities of ectodermal and mesodermal origin. It is found predominantly in females. We report a case of a two month-old baby girl who had dermal hypoplasia, atrophic skin lesions with telangiectasia in a linear pattern, fat herniations, papillomas and cleft of the upper lip, ectrodactyly, claw hands, microphthalmia and unusual association of gastrointestinal omphalocele