SACM - United Kingdom
Permanent URI for this collectionhttps://drepo.sdl.edu.sa/handle/20.500.14154/9667
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Item Restricted Exploring Factors Influencing Nurse Attrition in Intensive Care Unit in Critical Care in Saudi Arabia: A Systematic Review(Queens University Belfast, 2025-02-10) McKenna, Niall; Brown, MichaelBackground Methodology & search strategy Result Discussion conclusion9 0Item Restricted Enhancing Colorectal Cancer Screening Participation via Text Message Interventions(King's College London, 2024-09) Almoallem, Ghader; Round, Thomas; Hamad, WasimBackground: Colorectal cancer (CRC) ranks as the third most frequently diagnosed cancer globally and is a significant contributor to cancer-related deaths. Early detection through regular screening is crucial, as it greatly improves treatment outcomes and survival rates. However, screening participation for CRC remains insufficient, especially among minority groups. Text message interventions have been proposed as a cost-efficient and scalable solution to increase screening adherence. Objective: This systematic review and meta-analysis aimed to assess the effectiveness of text messaging interventions in enhancing CRC screening participation. Methods: A comprehensive search was conducted across four major databases Embase, PubMed, MEDLINE, and Cochrane up to August 2024. The review included randomized controlled trials (RCTs), observational studies, mixed-methods studies, and qualitative research that evaluated the impact of text message reminders on CRC screening rates. Data were extracted on study characteristics, intervention specifics, and screening outcomes. Meta-analyses were carried out to calculate pooled effect sizes of text message interventions compared to usual care. Results: Eighteen studies met the inclusion criteria, consisting of 12 RCTs, two observational studies, two mixed-methods studies, and two qualitative studies. The meta-analysis indicated that text message interventions significantly improved CRC screening uptake compared to usual care (pooled relative risk: 1.23, 95% CI: 1.12–1.36, p < 0.001). Sensitivity analyses validated the robustness of these results across different study designs and populations. Text message interventions were especially effective in low-income and underserved groups, where traditional outreach methods tend to be less successful. Furthermore, cost analysis from the reviewed studies highlighted that text messaging is a highly cost-effective method for promoting CRC screening. Conclusion: Text message interventions offer a scalable and effective approach to increasing participation in CRC screening programs. Their affordability, wide reach, and simplicity make them an ideal tool for public health systems, particularly those operating in resource-constrained settings. Despite these encouraging results, further research is needed to refine the content, timing, and cultural relevance of messages to ensure maximum impact across diverse populations. Incorporating text messaging into broader public health strategies could be crucial in alleviating the global burden of colorectal cancer.48 0Item Restricted Restrictive Versus Liberal or Standard Intravenous Fluid Administration in Patients with Sepsis or Septic Shock: A Systematic Review(Queen Mary University of London, 2024-07-31) Khogeer, Tariq; Prowle, JohnSepsis and septic shock are leading causes of morbidity and mortality worldwide, with effective management being critical to improving patient outcomes. Intravenous (IV) fluid resuscitation is a cornerstone of treatment in septic patients; however, the optimal fluid management strategy remains controversial. This systematic review examines the impact of restrictive versus liberal or standard fluid resuscitation strategies on mortality in patients with sepsis or septic shock. The review included eight randomized controlled trials (RCTs) involving 2,375 patients. The primary outcome was mortality within 90 days. Secondary outcomes included the use of mechanical ventilation, vasopressor requirements, renal replacement therapy, and the occurrence of adverse events such as limb ischemia and acute kidney injury. The findings suggest no significant difference in mortality between restrictive and liberal fluid administration. However, restrictive strategies may reduce the need for mechanical ventilation and vasopressor support. These results highlight the need for individualized fluid resuscitation strategies in septic patients, tailored to clinical circumstances. Further large-scale studies are recommended to confirm these findings and optimize fluid management protocols.13 0Item Restricted Evaluating C-reactive protein (CRP) and Interferon gamma-induced protein 10 (IP-10) as Biomarkers for Tuberculosis Treatment Monitoring: A Systematic Review on Adult Pulmonary Tuberculosis Treatment(Keele University, 2023-09-05) Alkhelaiwi, Weaam; Harrison, RebeccaBackground: Tuberculosis (TB) is an enduring global health menace that predominantly affects low- and middle-income nations. Despite medical advancements, TB continues to claim numerous lives every year, necessitating innovative solutions to enhance treatment and monitoring. Conventional strategies for monitoring the progress and outcomes of TB treatment often face challenges, especially in resource-limited settings. These limitations include delayed results, invasive procedures, and the need for sophisticated equipment. Consequently, the medical community is in dire need of efficient and reliable biomarkers that can serve as indicators of treatment response and disease progression. Objectives: The primary aim of this review was to meticulously investigate the potential effectiveness of C-reactive protein (CRP) and Interferon gamma-induced protein 10 (IP-10) as biomarkers for TB treatment monitoring. Specifically, this review sought to answer: "How effective are CRP and IP-10 in tracking treatment response in adults undergoing therapy for active pulmonary tuberculosis?" Methods: Guided by the stringent PRISMA 2020 statement guidelines, an exhaustive search of the literature was conducted, focusing on studies that shed light on CRP and IP-10 as prospective biomarkers for TB treatment tracking. Multiple databases were scoured, and a rigorous selection protocol was established, filtering out studies based on relevance, language, and other criteria. This meticulous approach ensured the inclusion of only the most pertinent studies that contribute significantly to the research question. Results: Out of an initial pool of 39 articles, six pivotal studies were selected for in depth review. These studies spanned a diverse range of geographical territories, from South Korea and Uganda to India and Gambia, offering a broad spectrum of insights. The collated results indicated that biomarker concentrations, notably IP-10 and CRP, exhibited significant fluctuations in sync with TB treatment stages and overall disease diagnosis. The consistency of IP-10 levels in monitoring therapeutic response was particularly pronounced in patients diagnosed with active TB. On the other hand, CRP levels displayed a discernible downward trend as the treatment progressed, underscoring its potential as a reliable indicator of therapeutic effectiveness. However, certain studies also illuminated the circumscribed role of IP-10 as a biomarker in regions heavily burdened with TB. This highlighted the imperative for context-specific evaluation before the widespread adoption of these biomarkers. Conclusions: The findings of this review underscore the promising potential of both CRP and IP-10 as innovative biomarkers for TB treatment monitoring. While IP-10 exhibits a pronounced capability in differentiating between active and latent TB infections, CRP's consistent decline during treatment suggests its pivotal role in evaluating therapeutic efficacy. Nevertheless, the practical adoption of these biomarkers in real-world scenarios mandates further extensive research, comprehensive validation trials, and tailored evaluations to account for regional and demographic variations. The incorporation of such biomarkers could revolutionize TB treatment monitoring, offering rapid, reliable, and non-invasive methods that could be particularly beneficial in resource-constrained settings.10 0Item Restricted Using Continuous Positive Airway Pressure with Hypoxemic Acute Respiratory Failure: A Systematic Review and Meta-Analysis of Randomised Controlled Trials(Saudi Digital Library, 2023-11-25) Alenazi, Bushra; Parekh, Dhruv; Grudzinska, FrancesBackground: Hypoxemic acute respiratory failure (hARF) is a common cause of emergency room and intensive care unit (ICU) admissions. Although the use of continuous positive airway pressure (CPAP) in this group of patients generally has steadily increased, the evidence supporting its use remains sparse. This systematic review and meta-analysis aims to summarise the findings of randomized controlled trials (RCTs) that have evaluated the need for intubation, and in-hospital mortality rate in patients with hARF treated specifically with CPAP compared to any other interventions. Method: CENTRAL, Embase, PubMed, CINAHL and Medline databases were searched. Studies including adults aged ≥ 18 years with hARF and RCTs that compared CPAP to any comparator/control were included. The studies were narratively and statistically analysed, and the outcomes assessed are intubation and in-hospital mortality rate. The risk of bias was assessed using the Cochrane risk of bias checklist for randomized control trials. Studies were reviewed in accordance with PRISMA guidelines. Results: Among 3488 studies identified. Six studies were eligible for inclusion involving 2,966 participants included in the meta-analyses and were descriptively synthesised. Results from the meta-analysis suggest reductions in intubation rate with CPAP compared to standard oxygen therapy (SOT) and high-flow nasal cannula (HFNC) (RR= 0.81, CI= 0.70 to 0.95, P-value=0.007). When doing subgroup analysis, CPAP suggests a reduction in the intubation rate with non-COVID-19 compared to COVID-19 studies. (P-value= 0.0010, 0.10, respectively). This study also suggests that helmet CPAP decreases the intubation rate in comparison to face mask CPAP (P-value <0.00001, 0.08, respectively). On the other hand, the study found that there was no significant difference in the in-hospital mortality rate between CPAP and other comparators (SOT and HFNC), (RR= 0.86, CI= 0.71 to 1.05) and a P-value of 0.13. This lack of significance was observed also in subgroup analysis in COVID-19 and non-COVID-19 studies. However, when looking at CPAP interventions using different interfaces, the risk ratio for face mask studies was not statically significant (RR=0.92, P-value=0.43), but the use of helmet CPAP was found to have a significant effect (risk ratio=0.23, P-value=0.0009). Conclusion: This systematic review highlights the available evidence to support the use of CPAP with hARF patients. Findings suggest that CPAP may reduce the need for intubation, especially in non-COVID-19 patients. However, CPAP has not been shown to have an effect on the in-hospital mortality rate. Using CPAP therapy with a helmet has shown to be a promising approach to lowering intubation and in-hospital mortality rates among this group of patients (hARF). Further studies are needed for a higher certainty of evidence. Other: This systematic review is registered with PROSPERO, CRD420234520233 0Item Restricted Osteoradionecrosis Prophylaxis by Pentoxifylline and Tocopherol Prior to Dental Extractions: A Systematic Review(Saudi Digital Library, 2022) Alleft, Abdullah; Leeson, RachelBackground and Objectives: Osteoradionecrosis (ORN) remains one of the most abysmal complications of head and neck radiotherapy (XRT). The advantageous and welcoming news of increased survivability for head and neck cancer patients came at the expense of increased risks of complications in general, including ORN. Consequently, this positive survival outcome provides plentiful of time for dental deterioration to occur, which may lead to more dental extractions, the main propagator for ORN. Therefore, preventing ORN became a pivotal matter for head and neck cancer patients. From the numerous preventative measures for ORN, prophylactic administration of Pentoxifylline and Tocopherol (PVe) appears promising, especially since many publications have demonstrated its success in treating ORN. However, recently multiple studies investigating PVe prophylactic use to prevent ORN came to fruition. This study aims to assess reported publications by employing a systematic review to investigate whether the prophylactic administration of PVe can prevents or reduces the incidence of ORN. Methods: The systematic review was done according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. An electronic database search on Medline (Ovid), Embase (Ovid), Cochrane Library, Web of Science and Google Scholar focusing on the prophylactic use of PVe to prevent ORN was conducted. Results: Out of two thousand five hundred and thirty-six (2536) publications, five (5) were included based on the patient/population, intervention, comparison, outcomes and studies type (PICOS) design for the prophylactic use of PVe before extraction and/or oral surgical procedure. This systematic review revealed out of 440 individuals, 19 developed ORN representing an incidence rate of 4.3%. However, when control groups and studies that were deemed high risk of bias or poor design were excluded, the incidence of ORN dropped to 2.5 % (9 out of 359 individuals). Both outcomes reveal a lower incidence of ORN compared to the established benchmark without any preventive measures of 7% and lower than the controlled group incidence of 11.5 % in one of the reviewed studies. Conclusion: This systematic review shows that current literature supports the prophylactic use of PVe to prevent ORN prior to dental extraction and other oral surgical intervention. Nevertheless, additional well-designed and prospective randomised controlled trial studies are needed to further validate the efficacy of PVe prophylaxis to prevent ORN before any oral surgical intervention.21 0