Background: Cesarean section is associated with moderate-to-severe postoperative pain, which may interfere with early maternal mobilization, breastfeeding, oral intake, maternal-infant interaction and overall postoperative recovery. Multimodal analgesia, incorporating neuraxial opioid analgesia with scheduled non-opioid analgesics and limited rescue opioid administration, has become an important component of enhanced recovery after cesarean delivery (ERAC). However, implementation and effectiveness may vary according to institutional practice and available resources. This study compared postoperative pain and early recovery following cesarean section between women receiving a multimodal/ERAC analgesic protocol and those receiving conventional postoperative analgesic management. Methods: This comparative clinical study was conducted at the Department of Anesthesia, 250 Bedded Hospital, Lalmonirhat, Rangpur, Bangladesh, from July 2025 to June 2026. A total of 100 women undergoing elective or uncomplicated cesarean section under spinal anesthesia were equally allocated to multimodal/ERAC analgesia (Group A, n=50) or conventional analgesia (Group B, n=50). Pain was assessed using a 0–10 VAS/NRS at 2, 6, 12 and 24 hours. Secondary outcomes included recovery parameters, rescue analgesic use, adverse effects, breastfeeding, hospital stay and maternal satisfaction. Results: Baseline demographic and obstetric characteristics were comparable between groups. Mean pain scores were significantly lower in Group A at 6, 12 and 24 hours. At 24 hours, the mean pain score was 2.2 ± 0.8 in Group A compared with 3.1 ± 1.0 in Group B (P<0.001). The multimodal group also demonstrated earlier ambulation (10.8 ± 3.1 vs. 14.7 ± 4.2 hours), earlier oral intake (3.8 ± 1.1 vs. 5.2 ± 1.5 hours), earlier catheter removal (10.4 ± 2.5 vs. 15.1 ± 3.8 hours), earlier spontaneous voiding (12.7 ± 3.0 vs. 17.5 ± 4.0 hours), lower rescue opioid requirement and shorter hospital stay. Maternal satisfaction was higher in the multimodal group. Nausea, vomiting and pruritus were slightly more frequent in Group A, consistent with exposure to neuraxial opioid, although serious adverse events were uncommon. Conclusion: A multimodal/ERAC analgesic strategy was associated with better postoperative pain control while facilitating earlier mobilization, oral intake, urinary recovery, breastfeeding and hospital discharge after uncomplicated cesarean section. Multimodal analgesia may therefore represent an effective opioid-sparing approach to postoperative cesarean care.

Preventable pediatric emergency admissions signal gaps in access, continuity, caregiver support and chronic-disease management. Emergency departments remain indispensable for severe illness, yet children with low-acuity infections, poorly controlled asthma, medication problems, delayed primary-care access or unresolved post-discharge needs may reach hospital when earlier community intervention could have been safer and more efficient. This integrative review examines how Saudi Arabia can reduce avoidable pediatric emergency use through coordinated primary, community, digital and hospital services. Recent evidence and authoritative frameworks were synthesized across prevention, timely access, chronic-care pathways, tele-triage, discharge transition, family capability, data integration and payment. The paper proposes a whole-pathway model that preserves rapid emergency access while creating reliable alternatives and feedback loops. Priority actions include same-day pediatric assessment, family-held action plans, proactive high-risk registries, school and pharmacy partnerships, virtual consultation, post-emergency follow-up within seventy-two hours and interoperable records. A balanced dashboard should measure safety, equity, experience and utilization rather than treating fewer admissions as the sole goal. Integrated pediatric care can improve outcomes, reduce fragmentation and advance Saudi Vision 2030 objectives for prevention, access, quality and value.

Digital transformation is reshaping maternal healthcare by extending clinical observation beyond conventional hospital visits and enabling continuous, data-supported relationships between pregnant women and healthcare professionals. Tele-obstetrics, remote pregnancy monitoring, wearable technologies, mobile health applications, artificial intelligence (AI), and clinical decision-support systems offer opportunities to improve accessibility, early risk recognition, continuity of care, and maternal safety. This review evaluates recent evidence on digital approaches to maternal healthcare and examines their relevance to Saudi Arabia. A structured review of peer-reviewed literature published primarily between 2020 and 2025 was conducted, with particular attention to telehealth in high-risk pregnancy, remote blood-pressure monitoring, gestational-diabetes management, wearable maternal and fetal sensors, AI-based pregnancy risk prediction, and clinical decision support. Evidence indicates that telehealth can reduce unnecessary face-to-face visits while maintaining maternal and neonatal outcomes in appropriately selected pregnancies. Remote blood-pressure monitoring can improve surveillance of hypertensive disorders and postpartum follow-up, while mobile health technologies can support glucose monitoring and self-management in gestational diabetes. AI-assisted clinical decision-support systems demonstrate potential for predicting complications and prioritizing high-risk patients, although external validation, bias, explainability, data privacy, and clinical integration remain significant challenges. Saudi Arabia provides a particularly favorable environment for digitally enabled maternity care because healthcare transformation under Vision 2030 increasingly emphasizes virtual care, prevention, integrated health records, artificial intelligence, and equitable access to specialized services. An integrated model combining remote monitoring, tele-obstetric consultation, electronic maternal records, automated alerts, and clinician-led decision-making could strengthen maternity services while maintaining patient safety and professional accountability.

Vitreoretinal surgery often achieves anatomical success; however, functional recovery differs markedly among eyes with similar disease presentations. Retinal imaging biomarkers help reduce this uncertainty by characterizing tissue composition, photoreceptor integrity, traction, perfusion, inflammation, and postoperative remodeling before these changes are evident in visual acuity. This structured review compiles evidence from 2020 to 2025 regarding optical coherence tomography, optical coherence tomography angiography, wide-field imaging, fundus autofluorescence, and emerging computational evaluations for predicting outcomes after surgery for epiretinal membrane, macular hole, rhegmatogenous retinal detachment, and tractional diabetic retinal disease. A translational framework is used, distinguishing preoperative risk stratification, intraoperative confirmation, early postoperative assessment, and longitudinal recovery. Across indications, the most consistent favorable prognostic indicators include preserved ellipsoid-zone and external-limiting-membrane continuity, limited inner retinal disorganization, reduced chronicity-related tissue deformation, smaller or more favorable lesion geometry, and early restoration of normal foveal architecture. In contrast, ectopic inner foveal layers, extensive disorganization of retinal inner layers, persistent subretinal fluid, outer retinal corrugation, hyperreflective inflammatory deposits, severe macular ischemia, and segmentation-unstable edema are associated with slower or incomplete recovery. No single metric demonstrates sufficient robustness across diseases, devices, and surgical techniques. The most effective prognostic approach merges with structural condition, lesion geometry, perfusion, symptom-relevant function, and temporal change. Standardized acquisition, masked grading, artifact reporting, external validation, and outcome definitions extending beyond distance acuity are necessary before imaging-derived scores can independently guide consent, timing, or individualized follow-up.

Foodborne diseases are illnesses resulting from the consumption of food contaminated with pathogenic microorganisms, their toxins, or harmful chemicals. The study was aimed to investigate the phytochemical constituents and antibacterial efficacy of some spices (Zingiber officinale, Allium sativa, Piper nigrum and Syzygium aromaticum) extracts against some food borne pathogens (Klebsiella spp, Salmonella spp, Shigella spp, and Escherichia coli). Ethanol extracts from the spices were prepared, screened for phytochemical constituents using conventional methods and tested for antibacterial activity using agar well diffusion methods. Phytochemical screening of the extracts showed that the extracts contain Alkaloid, Anthraquinone, saponin, tannin, phenol, steroid, flavonoid and terpenoid. Alkaloid was found to be the most abundant constituent. The result of Antibacterial activity of the extract showed that the extract demonstrated activity against the isolates. Based on the susceptibility of the organisms to the extracts, E. coli was found to be the highest susceptible organisms, followed Salmonella typhi while least activity was shown by Klebsiella. The Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) of the extracts range from 3.125 to 50 mg/ml. There is no significant difference on the susceptibility of the organisms against the extracts at p < 0.05. The results of present study have provided the justification for therapeutic potential of the extracts and also its use as dietary supplement for food flavouring and preservation.

Background: Healthcare-associated infections (HAIs) remain a major public health challenge worldwide, contributing significantly to patient morbidity, mortality, prolonged hospitalization, and increased healthcare costs. Nurses play a central role in the implementation of Infection Prevention and Control (IPC) measures; therefore, adequate awareness of IPC principles is essential for ensuring patient safety and reducing infection transmission within healthcare facilities. Objective: This study assessed the level of awareness of Infection Prevention and Control among nurses at a tertiary healthcare institution in Southern Nigeria and identified existing knowledge gaps that may hinder effective IPC implementation. Materials and Methods: A descriptive cross-sectional survey was conducted among 197 registered nurses at the Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria. Participants were selected using a simple random sampling technique. Data were collected using a structured self-administered questionnaire comprising socio-demographic variables and ten awareness-related items. Responses were measured on a five-point Likert scale. Data were analyzed using descriptive statistics, including frequencies, percentages, means, and standard deviations. A mean score of 3.0 and above was considered indicative of good awareness. Results: The overall awareness of IPC among nurses was high, with a global mean score of 3.76 ± 1.05. The highest awareness was recorded for the importance of hand hygiene in preventing infections (4.32 ± 0.78), familiarity with the proper use of personal protective equipment (4.09 ± 0.93), and understanding the rationale behind regular IPC training (4.04 ± 0.92). However, lower awareness scores were observed regarding adequacy of IPC training received (3.43 ± 1.14), being up-to-date with current IPC guidelines (3.43 ± 1.18), and regular review of IPC protocols (3.43 ± 1.18). Overall, 148 (75.2%) nurses demonstrated good awareness, while 49 (24.8%) had poor awareness. Conclusion: Nurses demonstrated good overall awareness of Infection Prevention and Control measures. Nevertheless, important gaps exist in continuous professional development, access to updated IPC guidelines, and routine review of institutional protocols. Strengthening regular training and dissemination of current IPC information may further improve awareness and support effective infection prevention practices.

Atrial fibrillation is a frequent presentation in emergency departments and cardiology clinics, yet the transition from acute recognition to durable stroke prevention remains uneven. In Saudi Arabia, the rising burden of cardiometabolic disease, ageing, renal impairment and fragmented follow-up creates a setting in which anticoagulation decisions are clinically important and operationally fragile. This review examines anticoagulation gaps, stroke-risk assessment and guideline-based care for adults with atrial fibrillation managed in Saudi emergency and cardiology settings. A structured narrative method was used to synthesise international guidelines, contemporary emergency-care evidence and Saudi literature published from 2020 to 2025. The review identifies recurring gaps: incomplete documentation of CHA2DS2-VASc or CHA2DS2-VA scores, uncertainty around direct oral anticoagulant dosing, persistent use of non-anticoagulant antiplatelet therapy for stroke prevention, delayed initiation after emergency discharge, limited renal-function reassessment, and variable cardiology follow-up. These gaps are not merely prescribing issues; they reflect competing priorities at presentation, inconsistent ownership between emergency physicians and cardiology teams, patient concerns about bleeding, and limited structured counselling. Guideline-based care should begin at first contact, with electrocardiographic confirmation, haemodynamic stabilisation, systematic stroke and bleeding risk assessment, renal and hepatic review, medication reconciliation, shared decision-making and a defined follow-up appointment before discharge. A Saudi model should combine emergency pathways, pharmacist-supported anticoagulant initiation, cardiology review for rhythm strategy, and quality indicators that track eligible anticoagulation, dose correctness and early review. Strengthening this pathway could reduce preventable stroke, avoid unnecessary admission and improve continuity for patients who currently move between episodic acute care and chronic cardiovascular management.