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Background: The prevalence of discharge against medical advice (DAMA) ranges from 1% to 2% in inpatient admissions and may reach up to 25.9% in some hospitals. The aim of this meta-analysis was to assess the prevalence, causes, and predictors of DAMA in the emergency departments. Methods: We conducted a systematic electronic database search for suitable studies from inception till 20th January 2020 in nine databases. Meta-analysis was used to pool the results. Results: Of the total 180 records screened, we included 14 studies. The overall prevalence rate of DAMA was 6.3% [95% confidence intervals (CI) = 3.41%-11.63%]. The most common cause of DAMA was not being content with the treatment or not agreeing with the diagnosis/treatment (19.93%; 95% CI = 11.02%-33.34%), followed by long waiting time (8.6%; 95% CI = 0.97%-47.45%) and financial problems (7.15%; 95% CI = 1.45-28.78). Regarding predictors, the reported significant unadjusted predictors were local emergency center [Odds ratios (OR) = 1.23%; 95% CI = 1.21-1.24%; p-value < 0.001], regional emergency center (OR = 0.83%; 95% CI = 0.82%- 0.84%; p-value < 0.001), and non-urgent triage (OR = 12.74%; 95% CI = 1.13%-143.97%; p-value = 0.040). In the same context, the significant adjusted predictors were ≤40 years (males) (OR = 3.94%; 95% CI = 1.31%-11.83%; p-value = 0.014), male gender (youth and middle-aged) (OR = 1.2%; 95% CI = 1.19%-1.21%; p-value < 0.001), and Male gender (aged group) (OR = 1.09%; 95% CI = 1.07%-1.11%; p-value < 0.001). Conclusion: DAMA prevalence in emergency departments is high. More attention should be devoted to those patients in relation to the possible DAMA causes for decreasing negative consequences resulted from committing DAMA. [SJEMed 2021; 2(1.000): 32-41]

Not Available [SJEMed 2020; 1(1.000): 1-1]

Hajj is a unique gathering with Mecca and Kaaba being spiritually important to many faiths across the globe, especially Muslims. This is because of the proclamation of the prophet's father, Ibrahaam, when he called all mankind to perform Hajj. That is why all Muslims on Earth feel that they have to visit Mecca and Kaaba on a specific date and time, and that is the reason this small location hosts one of the largest human gatherings in the world. Hajj is one of the five pillars of Islam that every financially and physically able Muslim must perform once in his/her lifetime. For 14 centuries countless millions of Muslim men and women from the four corners of the earth have undertaken pilgrimage to Mecca.In conclusion this review article confirm that Hajj is oldest and largest mass gathering in all mankind and there is some issues influence the health response such as size of gathering. diversity of population, climate and health facilities around hajj site, also we discuss the infectious and non infectious related illness in hajj and their prevention methods. Keywords: Hajj, Disaster medicine, Terrorism and mass casualty events