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Background: Breaking bad news encompasses conveying information that significantly impacts an individual's view of their present and future. In emergency departments (EDs), medical professionals often face the challenge of delivering distressing news. This study explored patient and family preferences for receiving bad news in the ED, considering sociodemographic factors such as education and gender. Methods: This cross-sectional study involved 304 patients from the ED of King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia. The participants were divided into four groups based on their gender and educational level. A p -value of <0.05 was considered statistically significant. Results: Patients with a high education level strongly preferred receiving full details regarding their medical condition and desired to be told privately. Considering gender differences, female patients preferred to communicate with their physicians through a formal and gentle approach. Whereas, male patients preferred receiving bad news through one of their family members. In addition, 51.3% of the participants (n = 156) indicated that they preferred their family members to be in a nearby waiting room while they were undergoing cardiopulmonary resuscitation (CPR). Conclusion: When emergency physicians deliver bad news to their patients or the patients' families, it is advisable to consider factors such as the patient's gender and educational level. Sitting face-to-face in a separate room was reported as the best way to deliver bad news to family members. Most importantly, patients wanted to learn more about their medical condition and have their family members waiting nearby while CPR was performed. [ABSTRACT FROM AUTHOR]

(1) Background: Food allergy (FA) is an immune-mediated hypersensitivity to foods, significantly contributing to childhood morbidity and mortality. This study aimed to assess the prevalence, characteristics, and influencing factors of parent-reported FAs among children in Saudi Arabia. (2) Methods: This cross-sectional study utilized a validated parental questionnaire distributed across all regions of Saudi Arabia. Data from 2130 participants were collected and analyzed using SPSS v. 26 and Prism software v. 10.3.0. (3) Results: Parent-reported FA prevalence was 15.2%. Egg was the most common allergen (6.2%), followed by tree nuts (4.1%), peanuts (4.0%), milk (3.8%), and sesame (3.2%). Significant geographical variations were observed, with the western region having the highest burden (p < 0.001). Older children had higher rates of shellfish and fish allergies. Parental allergies and co-existing asthma/drug allergies were positively associated with childhood FAs. (4) Conclusions: This study highlights a substantial burden of parent-reported FAs in Saudi Arabia, with regional variations in food allergen distribution. Parental allergies and co-existing allergic conditions may influence FA risk. [ABSTRACT FROM AUTHOR]

Infectious diseases are among the most frequent causes of hospital admission and a substantial contributor to morbidity and mortality. These diseases pose a persistent concern, particularly within the pediatric population, where delays or inappropriate management can result in serious harm. Additionally, infectious diseases contribute to overcrowding in pediatric emergency departments (EDs). This study aimed to explore the epidemiology, clinical presentation, diagnostics, outcome, and social and behavioral impacts of infectious diseases on child health. We conducted a retrospective, single-hospital study at a tertiary care center that is publicly funded and owned to serve the entire community. Pediatric patients with at least one or more chief complaints related to the respiratory system or infectious etiology were included. Data analysis was performed using SPSS to assess relationships between variables. A total of 15,106 patients were included, with a mean age of 3.80 years. The largest age group was toddlers (42.8%). Most cases (71.9%) were classified as urgent (Priority 3). Regarding patient outcomes, 76.1% were discharged after receiving appropriate treatment in the ED, and 22.9% required admission for further management. Nearly 38% of patients presented with a single complaint. Fever was the most frequent complaint across all groups. In summary, this study provides insights into the presentation of pediatric respiratory infectious diseases in the emergency room. The study revealed that toddlers were the most affected age group, with fever and cough being the common symptoms. [ABSTRACT FROM AUTHOR]

Objective: To assess the association between boarding time in the emergency department (ED) and increased patient mortality at the King Abdul-Aziz University Hospital in Jeddah, Saudi Arabia. Methods: A retrospective study was conducted on 28,066 patients admitted through the ED and discharged from January to December 2019 at the King Abdul-Aziz University Hospital in Jeddah, Saudi Arabia. Data on patients' demographics, age, nationality, arrival method, eligibility, triage level, and outcome (alive or dead) was collected from medical records. Results: This study found a strong link between patient mortality and boarding time, with patients who died experiencing significantly longer boarding times than those who survived. The average boarding time for those who died was more than 12 hours, compared to only 2.2% of those who did not. Additionally, the death rate was higher among non-eligible and male patients. Patients with injuries or orthopedic diseases had a notably increased likelihood of boarding for more than 12 hours. Both long-term boarding and non-eligibility for management were risk factors for death among the patients studied. Conclusion: This paper highlights the impact of protracted boarding times on patient outcomes and emphasizes the urgent need to take immediate steps to decrease ED boarding. [ABSTRACT FROM AUTHOR]

Pediatric neurological emergencies are a significant concern, often leading to high rates of admission to pediatric intensive care units and increased mortality rates. In Saudi Arabia, the emergency department (ED) is the main entry point for most patients in the healthcare system. This study aimed to provide a comprehensive overview of pediatric neurology visits to the ED, analyzing patient demographics, clinical presentations, and outcomes. The retrospective study was conducted at a large tertiary care center and examined 960 pediatric patients with neurological emergencies out of 24,088 pediatric ED visits. The study population consisted mainly of male participants (56.5%) and 43.5% female participants, with a mean age of 5.29 ± 4.19 years. School-age children (6-12 years) represented the largest population group (29.1%), and over a third of patients were triaged as 'resuscitation' (n = 332, 34.6%). Seizures (n = 317, 33.0%) and postictal states (n = 187, 19.5%) were the most common reasons for seeking emergency care, accounting for over half of all cases. There were statistically significant differences in provisional diagnosis and chief complaints across different age groups (P >0.001 and P <0.001, respectively). The most common outcome was discharge (n = 558; 58.1%), and the mean length of stay was 10.56 ± 20.33 hours. Neuro-emergencies in pediatrics are a concern and a leading cause of mortality, morbidities, and increased hospital visits. The observed variations in presentation and outcomes across age groups further emphasize the importance of tailored approaches. [ABSTRACT FROM AUTHOR]

Objective: To assess the association between boarding time in the emergency department (ED) and increased patient mortality at the King Abdul-Aziz University Hospital in Jeddah, Saudi Arabia. Methods: A retrospective study was conducted on 28,066 patients admitted through the ED and discharged from January to December 2019 at the King Abdul-Aziz University Hospital in Jeddah, Saudi Arabia. Data on patients' demographics, age, nationality, arrival method, eligibility, triage level, and outcome (alive or dead) was collected from medical records. Results: This study found a strong link between patient mortality and boarding time, with patients who died experiencing significantly longer boarding times than those who survived. The average boarding time for those who died was more than 12 hours, compared to only 2.2% of those who did not. Additionally, the death rate was higher among non-eligible and male patients. Patients with injuries or orthopedic diseases had a notably increased likelihood of boarding for more than 12 hours. Both long-term boarding and non-eligibility for management were risk factors for death among the patients studied. Conclusion: This paper highlights the impact of protracted boarding times on patient outcomes and emphasizes the urgent need to take immediate steps to decrease ED boarding. [ABSTRACT FROM AUTHOR]

Scurvy has become rare in modern societies, but should be considered in malnourished persons, alcoholics, and in infants on unsupplemented milk diets who present with musculoskeletal pain or a bleeding tendency. The diagnosis of scurvy can be challenging because of the rare incidence and vague and nonspecific early symptoms. We report here a case of scurvy in a young boy who presented with an inability to walk and severe musculoskeletal pain. The diagnosis was established based on his clinical picture, radiological appearance, and low serum level of vitamin C. The patient responded well to vitamin C supplementation with full resolution of his symptoms. He regained his ability to walk and his family was happy and satisfied with the outcome of treatment. Although the incidence of scurvy has become low in Saudi Arabia, it can still occur and early recognition is important because of the excellent prognosis.

Background: Social networking services (SNS) are a subcategory of social media that provide a useful tool for an individual's practical life and social relations. Since the impact of SNS on students' lives is a relatively neglected topic, we aimed to investigate the effect of social media on academic performance and self-esteem. Methods: A cross-sectional study was conducted with 373 medical students distributed across different academic years. Data was collected and analyzed using measures of central tendency to describe numerical variables, while frequencies and percentages were used for categorical variables. Pearson's chisquared test, Pearson's correlation coefficient, independent sample t-test, and the one-way analysis of variance (ANOVA) were used to identify relationships between the variables. All P values < 0.05 were considered significant using a 95% confidence interval and a 5% margin of error. Results: The majority of our sample believed that SNSs were useful, and 37.5% believed that social media positively affected their academic performance. However, no significant relationship was found between the time spent on social media and the students' grade point average (GPA). Conversely, there was a significant relationship between students' perceived addiction to social media and their self-worth, along with a positive correlation between GPA and self-esteem. Conclusion: Almost half of our participants agreed that social media is a helpful method for finding useful information. Nevertheless, excessive usage has been found to have a harmful effect on the students' health and self-esteem. [ABSTRACT FROM AUTHOR]

In the emergency department, the shoulder joint is the most common large-joint dislocated. The shoulder reduction can perform under Procedural sedation and analgesia or local intra-articular anesthetic injection. Intra-articular anesthesia is affordable, prevents potential side effects from intravenous sedatives, controls the pain and has a quick recovery time. This review article compares bupivacaine versus lidocaine in their safety, muscle relaxant effect, and effectiveness of anesthesia and analgesia during and after shoulder reduction. [ABSTRACT FROM AUTHOR]

Prolonged length of stay (LOS) in the emergency department (ED) is a key factor in measuring ED crowding worldwide. This study aimed to identify factors associated with prolonged LOS in the ED to better understand these factors at our institution. This was a retrospective record review examining factors associated with prolonged emergency department length of stay (>6-hours). Data were collected from electronic medical records, including patient demographics, chief complaints, triage acuity level, medication administration, diagnostic testing, consultations and patient disposition. In 2019, we recorded a total of 36,068 patient visits at our ED. Of these, 6439 (17.9%) patients met our definition of prolonged ED LOS (more than 6-hours) and were included in our analysis. Using multivariate analysis, we found that consulting services carried the highest predictor for prolonged ED LOS, with an adjusted odds ratio (aOR) of 23.0 and 95% confidence interval (CI) of 20.4-25.8. Followed by medication administration (aOR 2.0, CI 1.8-2.3), laboratory investigations (aOR 1.7, CI 1.5-2.0), radiological studies (aOR 1.8, CI 1.6-2.0), and non-Saudi nationality (aOR 1.3, CI 1.2-1.4), all p < 0.01. ED LOS may be reduced by optimizing the process of laboratory/radiology testing and medication administration. More importantly however, implementing a timeframe monitoring system for consultations while emphasizing accelerated decision-making and disposition for patients can reduce ED LOS. [ABSTRACT FROM AUTHOR]

Background and objective Ramadan is the Muslim's holiest month; it is a time when believers engage in special practices that include fasting from dawn till dusk and making cultural and dietary modifications in their everyday lives. The impact of Ramadan on human activity, sleeping patterns, and circadian rhythms of hormones have been addressed in the literature. Fasting, which constitutes the main pillar of practices during Ramadan and lasts from sunrise to sunset, can significantly affect common health conditions, leading many to seek medical care in the Emergency Department (ED). Hence, it is important to understand the pattern of ED visits and understand the impact caused by fasting during this holy month in a Muslim-majority country. In light of this, this study aimed to gather new insights into the pattern of ED visits during Ramadan at a busy tertiary care center in the period from 2019 to 2021. Methods This study was conducted by reviewing the hospital health information system to gather relevant information in May 2022. Data of patients who visited the ED during Ramadan were collected, as well as during a month prior to and after Ramadan for the purpose of comparison. Sociodemographic characteristics and clinical profiles were collected for analysis.  Results The total number of ED visits in the three months of Ramadan during the study period (three years) was 33,142, all of which were included in our analysis. Sociodemographic data were analyzed for patients who visited the ED during the month of Ramadan and the two lunar months that precede and succeed Ramadan (Shaban and Shawal). Fever was the most common complaint (16.5%), followed by abdominal pain (14%). When analyzing the findings based on patient age groups, fever was found to be the most prevalent complaint in both adults (15.6%) and pediatric patients (34.4%). Of the total ED patient visits, 7,527 patients were admitted for further care, and 197 patients deceased. Conclusion Our study findings illustrate the change in ED visit patterns during the month of Ramadan in a Muslim-majority country. Also, the type of complaints was affected significantly due to the ongoing coronavirus disease 2019 (COVID-19) pandemic during the study period. The outcomes in patients reflected substantial progress and outcomes in the ED. These findings highlight that analyzing ED data can help provide accurate information that can be used to help modify/adjust the quality of services provided in the ED. However, these modifications may affect all hospital facilities, not just the ED., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Khojah et al.)

We report a 65-year-old lady who presented with rapidly progressive dementia and was found to have Creutzfeldt-Jacob disease (CJD). On reviewing the literature, there have been only 3 case reports of CJD from Saudi Arabia. Our aim is to report this rare disease and to include it in the differential diagnosis of rapidly progressive dementia in our practice.