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Background: Induction of labor (IOL) is a frequent obstetric intervention used for a variety of reasons, including post-date gestation. The fundamental goal of IOL is to obtain the best maternal outcomes while lowering gestational morbidity and death. However, IOL is not always effective and may require an emergency caesarean section. Several IOL protocols were developed to increase success rates and decrease the number of caesarean section deliveries; however, adherence to these standards has not been widely reported. The purpose of this study was to evaluate the effectiveness and compliance of various IOL regimens in King Fahad Medical City, Saudi Arabia.

Methods: This was a retrospective chart review of women who presented to the Women’s Specialized Hospital in KGMC between January and December 2015 and underwent IOL. Data collected included demographics, medical and obstetric history, IOL indications, and related data.

Results: A total of 346 women were enrolled; the largest proportion was nulliparous (37.3%), and more than one-half were at 36-39 gestational weeks of pregnancy. The major cause of IOL was reduced fetal movement (15.3%). The rate of adherence to protocols was 98%, and the success rate of IOL was 98.6%. Most women delivered normally via the vagina (70.3%).

Conclusion: Adherence to the IOL protocol was high, which led to a high rate of IOL success and a high rate of normal vaginal delivery. The indication for IOL was mainly post-date pregnancy, and prostin was the most used agent for IOL.

Background: Healthcare workers (HCWs) face a multitude of occupational hazards, leading to a high burden of work-related injuries. Many of these injuries necessitate treatment in emergency departments (EDs), yet a comprehensive understanding of their characteristics within this specific context is evolving. This article aimed to synthesize existing evidence on the types, causes, and characteristics of occupational injuries among HCWs that are treated in or reported from ED settings.

Methods: A literature search through PubMed, Scopus, Web of Science, and Cochrane was performed to select the included studies. Data on study design, setting, participant characteristics, injury types, causes of injury, risk factors, and preventive measures were extracted and synthesized primarily from studies reporting ED-treated injuries.

Results: The included studies, predominantly from the USA with two from the Middle East, varied in design and specific HCW populations [emergency medical services (EMS) personnel, hospital-based HCWs, paramedicine clinicians]. Sprains and strains, and exposures (blood/body fluid, harmful substances) were consistently high-prevalence injury types. Leading causes of injuries included body motion/overexertion, transportation incidents (especially for EMS), and exposures. For HCWs in hospital settings, needlestick injuries and slips, trips, and falls were also prominent. Workplace violence was a significant cause of injury, particularly for hospital staff. Risk factors varied by HCW type and setting but included lifting/patient handling, inadequate personal protective equipment (PPE) use, and environmental hazards.

Conclusion: Occupational injuries requiring ED visits are a significant concern across various HCW groups. Musculoskeletal injuries, exposures, and transportation-related incidents are major contributors, particularly for EMS. Workplace violence and sharps injuries are critical issues within hospital settings. Targeted interventions focusing on ergonomic support, PPE adherence, violence prevention, and enhanced safety protocols are crucial for mitigating these risks. Improved, standardized data collection, especially for ED-treated occupational injuries, is needed globally.

Background: The pressure of musculoskeletal pain (MSP) influences nurses’ jobs and makes it difficult for them to have a good quality of life. Experts have researched this issue a lot, but they do not fully understand how individual, lifestyle, and job-related aspects contribute to MSP.

Aim of Work: This study aimed to look into the number of nurses affected by MSP and analyze connections between MSP and certain personal, habitual, and work characteristics, especially with their exercise patterns and body mass index (BMI).

Methods: The survey was carried out among 293 nurses who were working in several hospital departments. Information collected included demographics, BMI, whether people are right- or left-handed, their usual type of exercise (as well as its length), professional experience, and how the tasks of work were organized. It was investigated how many cases of MSP were detected in various areas and regions throughout the last year. The authors used statistics to see if there was any link between MSP and various risk factors.

Results: Most people (62.5%) visited the doctor for back pain in the lower back, while upper back pain was reported by 39.2% and neck pain was reported by 38.9%. A link was found between MSP and BMI, and both nurses who were underweight and the ones who were overweight were more likely to have pain (p = 0.015). Routine exercise was actually found to increase a person’s MSP rate (p = 0.035). Doing weight exercises decreased the chances of MSP, but more nurses with MSP exercised through cardiovascular activities (p = 0.004). Exercise lasting less than an hour a week and working for fewer than 6 consecutive hours were also connected to more cases of MSP (p-values of 0.000 and 0.002). There was no connection between age, gender, left- or right-handedness, practice time, position, the department people work in, or being on shift work.

Conclusion: There are many workers in the nursing profession with MSP, and these workers tend to have complicated associations with various personal and professional factors. The protective effect of weight training and the unexpected findings regarding exercise and work hours highlight the need for tailored preventive strategies and further research into occupational health interventions.

Background: Work stress among health professionals is an increasing area of concern, which adds to the risk of cardiovascular disease (CVD). Stressful work conditions can also contribute to poor health habits like smoking and a lack of physical exercise when experienced over a prolonged period.

Aim: To evaluate the relationship between occupational stress and cardiovascular risk factors in Saudi Arabian healthcare workers.

Methods: A cross-sectional survey of 303 healthcare workers in Care Medical Hospital, Riyadh, Saudi Arabia was performed with the use of a structured questionnaire that covered demographic data, level of occupational stress, and cardiovascular risk factors such as blood pressure, blood sugar, body mass index (BMI), smoking status, physical activity, and chronic disease history. Descriptive and inferential statistical tests were used to compute associations through statistical analyses.

Results: The majority of healthcare employees identified a low level of occupational stress; yet, the stress level was significantly related to younger age, marital status, smoking, and hypertension (p < 0.05). The level of blood sugar was surprisingly greater in the non-stressed group (p = 0.011). The researchers found no significant differences in BMI or the prevalence of diabetes between stressed and non-stressed groups.

Conclusion: The results obtained show that occupational stress is closely related to certain cardiovascular risk factors, in particular, smoking and hypertension. Health care is a high-stress environment that requires targeted stress management and wellness programs to help eliminate long-term CVD risk factors.

Not applicable 

Background: Physician burnout is a critical occupational phenomenon, compromising physician well-being, patient care quality, and healthcare system sustainability. In response, numerous systematic reviews and meta-analyses (SR/MAs) have evaluated interventions aimed at mitigating burnout. However, the proliferation of these reviews has created a complex and often contradictory evidence landscape, making it difficult for decision-makers to identify the most effective strategies. This umbrella review, therefore, synthesizes and critically appraises this body of secondary evidence to provide a clear, high-level summary of what is known about preventing and reducing physician burnout.

Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines, a systematic search of four major databases was conducted. We included SR/MAs that evaluated individual- or organization-directed interventions to reduce physician burnout. Two reviewers independently performed study selection, data extraction, and quality appraisal using the Joanna Briggs Institute checklist. Findings were synthesized narratively.

Results: Thirteen SR/MAs met the inclusion criteria. A prominent and recurring finding was that organization- directed interventions were associated with larger and more significant reductions in burnout compared to individual-focused strategies. Meta-analyses reported that the effect size for organizational changes was, in some cases, more than double that of individual interventions. While individual approaches like mindfulness demonstrated small, positive effects, particularly on emotional exhaustion, the overall evidence base was limited by significant heterogeneity and methodological weaknesses in the underlying primary studies.

Conclusion: The evidence strongly indicates that organization-directed strategies addressing systemic issues are more effective than interventions targeting individuals alone. The most promising path forward involves a comprehensive, bundled approach that prioritizes fixing the workplace while simultaneously offering supportive, evidence-based resources to physicians. Healthcare organizations must focus on implementing system- level changes to create healthier and more sustainable clinical work environments.

Background: Cardiovascular diseases (CVDs) constitute the leading causes of mortality worldwide, and prevention measures are particularly crucial among middle-aged and older populations. The increasing prevalence of obesity, diabetes, and sedentary lifestyles is contributing to the rise in CVD prevalence in Saudi Arabia.

Objective: To examine knowledge, attitudes, and practices (KAP) on prevention of heart disease among adults of 40 years and older who visit a care hospital.

Methods: A cross-sectional survey of 309 hospital attendees was performed with a structured questionnaire assessing aspects of demographic factors, knowledge of CVD risk factors, attitudes toward prevention, and self-reported prevention practices. Associations were evaluated using descriptive statistics and inferential analyses.

Results: Although more than 80% of the participants gave positive answers concerning their attitudes toward the prevention of heart diseases, only half of them had the proper knowledge, and preventive measures like routine screening were not consistent. Screening behaviors were reported to be better in men and those with higher education. Only one-quarter remembered a health care provider telling them they were overweight.

Conclusion: Knowledge gaps and low levels of participation in preventive practices are alarming although opinions are favorable. These gaps should be addressed through improved health education, regular counselling by healthcare providers, and culturally specific interventions that would lead to better long-term outcomes in cardiovascular health.

Background: Evaluating antibiotic prescribing patterns is important to enhancing patient safety and healthcare quality. According to the World Health Organization (WHO), antibiotics are the most commonly prescribed medication in emergency departments (EDs), where 20%-50% of prescribed antibiotics are unnecessary and contribute to antimicrobial resistance (AMR). AMR is directly responsible for 1.27 million deaths worldwide annually. Increasing prevalence of AMR in Saudi Arabia underscores the urgent need to assess antibiotic utilization.

Objective: To assess antibiotic prescribing patterns at the ED of Care Medical Al-Malaz (CMM) using the WHO/ International Network of Rational Use of Drugs (INRUD) indicators, compare them with the WHO benchmark data, and support antimicrobial stewardship improvements.

Methods: A retrospective cross-sectional study analyzed adult ED antibiotic prescriptions at CMM (October- December 2024). The WHO/INRUD prescribing indicators were used to evaluate trends in antibiotic patterns. Key metrics included average drugs per encounter, generic prescribing, and rates of antibiotic and injection use.

Results: This retrospective study analyzed 14,893 ED encounters, identifying 2,775 eligible prescriptions with 3,251 antibiotics. Oral antibiotics were prescribed (73.2%), and Watch-antibiotic agents (67.3%) predominated, mainly macrolides (30.4%) and cephalosporins (28.3%). The average number of drugs per encounter (3.9) and antibiotics prescribed in 32.0% exceeded the WHO standards. Generic prescribing (100%) and injection rates (20.9%) met the standard, and essential drug compliance was 99.56%. Culture testing was performed in only 59 cases with over 2,775 patients.

Conclusion: Antibiotic prescribing at the ED of CMM exceeds the WHO guidelines, driven by high polypharmacy, irrational antibiotic use, reliance on Watch-group antibiotics, and higher empirical treatment with limited diagnostic testing. These findings underscore the urgent need to enhance antimicrobial stewardship and prescribing practices.

Background: Chest wall sarcoma (CWS) is a rare and complex malignant tumor. CWS is an aggressive and heterogeneous tumor that represents a formidable challenge to clinicians. Synovial sarcoma of chest wall is a rare entity, and there are no sufficient data on its incidence and management.

Case Presentation: Here, we present a 35-year-old lady who received four cycles of chemotherapy for left breast cancer and excision of lateral chest wall superficial mass. The current imaging of the patient revealed a large CWS invading the pleura and was in very close proximity to the left lung and pericardium, with ribs destruction. The patient underwent resection of four ribs, the whole left breast and axillary lymph node, followed by chest wall reconstruction using plates. The patient underwent resection and reconstruction as she revealed no evidence of metastasis. The procedure went well, with no postoperative complications indicating the possibility of performing reconstruction promptly following resection.

Conclusion: The pathological diagnosis of the patient suggested synovial sarcoma; therefore, large synovial sarcoma of the chest wall is a rare condition that can be managed by total resection of the breast, chest wall, and lymph node.

Pesticides are used in a variety of circumstances, including agriculture and public health activities. Pesticides, on the other hand, have a deleterious influence on human health, with effects ranging from short term to long term. We focus on the long-term effects of pesticide exposure on human health. The literature on the current subject was collected through web research using various terms. This review was written based on eligible articles with precise titles. Pesticides are linked to a variety of negative health effects, ranging from short-term symptoms like nausea and headaches to long-term serious effects like cancer. Pesticides are risk factors that have been connected to a variety of serious ailments and illnesses over time. However, such risk and linkage are difficult to accurately deduce and explain because most diseases that need prolonged exposure also have a number of additional risk factors that can be included and function synergistically with pesticides to promote disease development. As a result, it is possible to conclude that long-term pesticide exposure poses a number of dangers to human health, although further research is required.