Jahra Hospital

Endoscopic retrograde cholangiopancreatography (ERCP) remains a cornerstone therapeutic intervention for pancreatobiliary disease but is associated with serious adverse events. Bleeding related to endoscopic sphincterotomy or periampullary manipulation may be difficult to control because of anatomic constraints and patient-related risk factors. PuraStat™ is a transparent self-assembling peptide (SAP) hydrogel that promotes hemostasis and healing. Data specific to the efficacy of SAP in ERCP-related bleeding remains limited. We performed a multicenter, prospective, observational study including consecutive ERCP procedures between January 2022 and December 2025 in which SAP was used to treat ERCP-related bleeding (intraprocedural bleeding (IPB) or delayed bleeding) and prophylactic application for prevention of delayed bleeding after sphincterotomy in high-risk patients. The primary outcome was immediate hemostasis, and secondary outcomes included technical success, 30-day rebleeding, and adverse events related to use of SAP. A total of 138 patients were included. The mean age was 51.3 years (SD 16.8), with 91 (65.9

Benign Paroxysmal Positional Vertigo (BPPV) is a common vestibular disorder characterized by a high recurrence rate, which poses a significant challenge for long-term management. A hypothesized link between vitamin D deficiency and otoconial dysfunction suggests that supplementation could be a viable preventive strategy. However, evidence from early studies has been inconsistent. This systematic review aims to synthesize the current evidence from randomized controlled trials (RCTs) on the efficacy of vitamin D supplementation in preventing BPPV recurrence. A systematic literature search for RCTs was conducted across PubMed, Scopus, CENTRAL, and Web of Science up to September 2025. We included trials comparing vitamin D supplementation against placebo or no intervention in adult patients with BPPV. The primary outcome was the BPPV recurrence rate. Secondary outcomes included time to first recurrence and adverse events. BPPV recurrence was pooled using STATA v. 19, and the risk ratio (RR). Five RCTs involving 1,118 patients were included. Vitamin D supplementation significantly reduced the risk of BPPV recurrence compared to control groups (RR: 0.33; 95

BACKGROUND:Spinal needle fracture during spinal anaesthesia is a rare but potentially serious complication, particularly in obstetric practice where neuraxial techniques are frequently used. We report a series of three cases of spinal needle fracture during attempted spinal anaesthesia for caesarean delivery and describe a common technical mechanism and management approach. CASE SERIES:Three patients with obesity had an attempted spinal anaesthetic for caesarean delivery with a fine-gauge pencil-point spinal needle through an introducer. In all cases, fracture occurred during needle redirection while the introducer remained stationary. The neuraxial attempt was abandoned and caesarean delivery proceeded under general anaesthesia in all three cases. Postpartum imaging with computed tomography was used to localise the retained fragments, which were subsequently removed surgically. Neurologic assessment during admission and follow-up at two weeks and one month demonstrated no neurologic deficits in any patient. CONCLUSION:Spinal needle fracture can occur when redirection of a fine spinal needle is attempted through a fixed introducer. Awareness of this mechanism, careful technique, and early imaging are essential to reduce risk and guide management in this rare complication.

Background: Brolucizumab is an intravitreal anti-vascular endothelial growth factor (anti-VEGF) agent developed to improve retinal drying and treatment durability in diabetic eye disease. However, its overall efficacy and safety in diabetic macular edema (DME) and diabetic retinopathy remain uncertain because available trials differ in population, comparator, dosing schedule, and follow-up. Methods: We searched PubMed, Cochrane Library, Scopus, and Web of Science from inception to 25 April 2026. Randomized controlled trials evaluating intravitreal brolucizumab in adults with DME, diabetic retinopathy, or proliferative diabetic retinopathy (PDR) were included. Comparators were aflibercept, panretinal photocoagulation, or other active/conventional treatments. The main efficacy outcomes were change in best-corrected visual acuity (BCVA) and central subfield thickness/central subfield foveal thickness (CST/CSFT). Safety outcomes included ocular, non-ocular, serious ocular, and serious non-ocular adverse events. Random-effects meta-analyses were performed. Results: Five reports representing four phase 3 randomized controlled trials were included, enrolling 2132 participants overall; the four-trial primary 6 mg analyses included 1942 participants. Brolucizumab was not associated with a significant improvement in BCVA compared with control treatment (mean difference [MD], 1.21 letters; 95% confidence interval [CI], −1.12 to 3.54; p = 0.3; I2 = 85.1%). However, brolucizumab significantly reduced CST/CSFT (MD −24.45 µm, 95% CI −47.43 to −1.47; p = 0.0370; I2 = 78.2%). No statistically significant differences were detected between groups in the assessed safety outcomes, including ocular adverse events (risk ratio [RR], 0.88), non-ocular adverse events (RR 1.00), serious ocular adverse events (RR 0.63), and serious non-ocular adverse events (RR 0.89). Separate analyses of brolucizumab-specific ocular events showed no statistically significant differences for intraocular inflammation (RR 2.35, 95% CI 0.36–15.42), retinal vasculitis (RR 2.10, 95% CI 0.22–20.10), or retinal vascular occlusion (RR 2.13, 95% CI 0.46–9.87); however, estimates were imprecise because of the small number of events. Conclusions: Across the four included trials, brolucizumab was not associated with a statistically significant difference in BCVA compared with control treatment. In the three DME trials, brolucizumab achieved a greater reduction in CST/CSFT. It may be useful for selected DME patients, while its role in PDR requires longer-term evidence.

The convergence of Internet of Things (IoT) devices and artificial intelligence (AI) in cosmetic health offers significant potential for preventive healthcare and personalized beauty-health integration. Despite market growth, implementation of IoT-AI technologies remains fragmented due to misalignment between technical capabilities and social systems. This perspective article uses sociotechnical-system analysis to examine implementation challenges in digital beauty-health initiatives. The analysis revealed that devices prioritized technical accuracy over integration with user routines, applications achieved consumer adoption while creating workflow challenges for healthcare systems, and algorithms exhibited performance disparities across populations. Studies on sociotechnical systems in healthcare demonstrate that successful implementation requires joint optimization across technical infrastructure, social systems, organizational contexts, and environmental factors. We propose establishing relevant sociotechnical standards, validating integration through diverse trials, and achieving healthcare alignment to this end. The priority areas include UV monitoring, skin barrier assessment, and AI-driven personalization. Without coordinated action addressing accuracy, workflow integration, and algorithmic fairness, cosmetic IoT-AI risks amplifying existing disparities rather than democratizing personalized cosmetic health.